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NHS warned focus on finance risks 'disastrous consequence'


The chair of the inquiry into care failings at Morecambe Bay has warned of a “disastrous consequence” for the NHS if it focuses too much on financial savings at the expense of patient safety.

Bill Kirkup, who led the investigation into maternal and infant deaths at the University Hospitals of Morecambe Bay Foundation Trust, said his fear was that, as the system sought to bring budgets under control, people would be “distracted” from ensuring safety and past mistakes would be repeated.

Dr Kirkup said: “I don’t think that in the medium term there is any dichotomy between pursuing quality and pursuing efficiency because high quality care is more efficient; you get it right first time.

“Just because of the financial position we are in at the moment, we are going to see that people’s priorities have to be focused on balancing the books, and that will distract them from patient safety and other aspects of quality,” he said.

“That would be a really disastrous consequence of all of this,” he said. “One of the major criticisms of people at Morecambe Bay is that they didn’t learn when things went wrong and they kept on making the same mistakes.

“There is a danger here that the national system will replicate that on a much wider basis, we will fail to learn the lessons and we will have other instances of disaster if we do that,” he told Nursing Times’ sister title Health Service Journal.

Dr Kirkup echoed similar comments from Sir Robert Francis after the Mid Staffordshire public inquiry, warning that some NHS trusts “have elements” of the problems at Morecambe Bay.

“Unless we address those they will fester and they will cause problems in the future,” he said.

“We are going to see that people’s priorities have to be focused on balancing the books, and that will distract them from patient safety”

Bill Kirkup

He highlighted the focus at Morecambe Bay on achieving foundation trust status, which he said led to “improper behaviour” by the trust and individuals. He warned this could be repeated with organisations focusing on implementing new care models and the NHS Five Year Forward View.

Dr Kirkup also expressed concern over a lack of action following his report, published in March.

The inquiry found “failures at almost every level of the NHS”, which combined to create “a lethal mix” causing the avoidable deaths of at least 11 babies and one mother.

Dr Kirkup said he was troubled by the lack of a “national steer” to the rest of the NHS about the lessons from Morecambe Bay.

He added: “The [Care Quality Commission] are taking it very seriously but I am less sure about what is happening at NHS England. Apart from a brief call when the national maternity review was set up, I haven’t really heard anything.”

He said he expected more details in the coming months but warned the time that was passing without action was a “missed opportunity”.

He said he was worried nothing was happening in relation to his recommendation of a review of all clinical and geographically isolated units to ensure safe services.

“I know other people share the concern there might be nothing happening on that… and the fear is that, if we don’t address the origins of those problems, we will have further examples,” he said.



Readers' comments (2)

  • The thing is, the NHS could save literally hundreds of millions and be much safer if there was more standardisation, be it equipment, protocols or even headed notepaper.

    Unsuitable or offensive? Report this comment

  • michael stone

    A common theme seems to be emerging here - the authors of 'heavy-weight' reports, which Goverment and NHS usually initially expresses 'support for', coming out during the following year or two with suggestions that their recommendations are not being sensibly acted on.

    Mind you, it is probably an age-old theme.

    redpaddys12 | 27-Jun-2015 2:48 am

    The comment that the NHS doesn't use its size well, in terms of collective purchasing is one other people make besides you: but that would require 'one NHS' and in reality it is split into lots of separate pieces, isn't it ?

    There do seem to be a few instances of this 'using its massive weight', but I'm not sure that there are many - one situation where it does seem to happen, is in NICE's 'negotiations' to reduce the price at which drugs are supplied to the NHS, by failing to put them on the 'recommended/value-for-money' list unless the price comes down to something more 'reasonable'.

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