Patients should be treated in the community rather than in hospitals because they can be “dangerous places”, some of the UK’s leading doctors have warned.
The NHS Alliance, which represents GPs and primary care staff, said that all non-urgent care should be shifted from hospitals into the community as an “immediate imperative” to keep people safe.
The appeal comes as the government’s new health adviser warned that a robust new culture was needed in the NHS to restore public trust to the health service.
Professor Don Berwick, who has been appointed to lead a review of patient safety in the NHS in the wake of the Mid Staffordshire hospital scandal, said that “zero harm” was the only way for the NHS to go, saying: “Why should we tolerate a single injury?”
The NHS Alliance said that only the most serious cases should be treated in hospital, as they “dangerous places” shunned by their own medical staff, the Times said.
In a letter to the newspaper the alliance’s president Dr Chris Drinkwater and chairman Dr Michael Dixon said: “If we are to put people before numbers and achieve high quality of care, as well as keeping an NHS free at the point of need for future generations we must, as an immediate imperative, shift all non-urgent care from hospital into the community.”
The alliance is also calling for the appointment of a GP with the same level of seniority as the Chief Medical Officer.
Dr Dixon told The Times: “We need to work towards the point when acute hospital admissions should be regarded as a failure rather than a default position.
“Hospitals can be dangerous, particularly for older patients and those with long-term conditions. There is a risk of infection and nutrition is complicated for those who cannot feed themselves.
“We should aim to keep them out of hospital as long as possible.”
He added: “Primary care holds the key to improving patient health. Over the past few years there has been an enormous shift (of resources) from primary to secondary care. Now people are fighting their own bit of their health corner.”
Prof Berwick, who used to advise US president Barack Obama, told the Daily Telegraph the NHS could become the safest health care system in the world, and should aspire to be as safe as the aviation industry.
Citing the Mid Staffordshire “tragedy” as a catalyst for improvements, he said “Zero harm is morally and ethically the right way to go. Why should we tolerate a single injury? There is no reason why English health care cannot aspire to be and become the safest health care in the world.”
But he said attitudes needed to change so that “no harm should be regarded as acceptable.
“That may be very aspirational, but in the world-class safety systems they generally have an attitude that even a single injury is problematic.
“Airlines have now achieved safety that many would have thought impossible in such a complex area.”
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