A culture change is needed to stop the NHS wasting as much as £2.5bn a year on mistakes made in hospitals, according to the health secretary.
Jeremy Hunt has appealed to hospital staff to recognise the impact that poor care has on finances, following the release of a report by economic consultants Frontier Economics on Thursday.
“We could potentially release resources for additional nurses, additional training, and additional time to care”
The report, commissioned by the government, found the cost of errors in patient safety, which includes the cost of extra treatment, bed space and nursing care as well as huge compensation pay-outs, costs the NHS between £1bn and 2.5bn a year.
But the Royal College of Nursing argued poor care is a result of understaffing on wards and not because nurses are unaware of how to prevent mistakes.
In a speech to staff at Birmingham Children’s Hospital on Thursday, Mr Hunt appealed in particular to trust directors and nurses.
He said: “I want every director of every hospital trust to understand the impact this harm is having not just on their patients, but also on their finances.
“And I want every nurse in the country to understand that if we work together to make the NHS the safest healthcare organisation in the world, we could potentially release resources for additional nurses, additional training, and additional time to care… nobody should be in any doubt that the path to lower cost is the same as the path to safer care.”
“Falls and preventable conditions such as pressure ulcers happen when there are not enough staff on a ward to care properly for every patient”
He added: “World class care is not just better for patients, it reduces costs for the NHS as well… more resources should be invested in improving patient care rather than wasted on picking up the pieces when things go wrong.
“The culture change we need to develop has to come from inside, not because hospitals are being forced from the outside. If you’re short of money, poor care is about the most wasteful and expensive thing you can do,” said Mr Hunt.
“I hope therefore that from today in hospital board meetings up and down the country, one simple change happens: patient experience and patient safety are not discussed separately to finances – but as two sides of the same coin,” he added.
Last year the NHS spent £1.3bn on payouts after being sued by patients over care errors.
Four areas of poor patient safety highlighted by the Department of Health include falls and trips, bed ulcers, urinary infections caused by poorly fitted catheters, and deep vein thrombosis, which together cost the NHS an estimated £200m a year in extra care.
The DH has calculated this is equivalent to employing nearly 4,000 ward nurses (see table below):
The total cost for treatment, bed space and nurses time:
|Average extra days in bed||Cost per patient||Est. cost a year to NHS||Equivalent in ward nurses|
|Pressure ulcer||12||£2,549||£49m||950 a year|
|Catheter induced UTI||10||£2,523||£67m||1,300 a year|
|Venous thromboembolism||8||£2,888||£53m||1,030 a year|
|A fall||3||£1,215||£36m||690 a year|
But Peter Carter, chief executive and general secretary of the RCN, said the government needed to invest in more staff before patient care can be improved.
“Every nurse’s first priority is patient safety, and they are well aware of the effects of poor care,” he said. “Falls and preventable conditions such as pressure ulcers happen when there are not enough staff on a ward to care properly for every patient, not because nurses are unaware that these things should be prevented.
“Poor care is more expensive and preventing it will save money but poor care is usually caused by a lack of investment. If there are not enough nurses on a ward to care for vulnerable patients, there will inevitably be more falls and more preventable conditions,” said Mr Carter.
“Though these proposals are well intended, logic suggests that you need to invest in additional staff first, and then you will find that your short term investment leads to longer-term savings,” he added.
Chair of patients’ watchdog Healthwatch England, Anna Bradley, said: “The principle behind this initiative is absolutely right – what is good for patients is ultimately often also cheaper for the system.
“To make this work we need a compassionate and effective complaints system that addresses people’s concerns when things go wrong and works with them to improve services for the future,” she said.
Labour health spokesman Jamie Reed said: “Under David Cameron, thousands of nurses and frontline staff have been lost while £3bn has been wasted on a reckless NHS reorganisation, putting patient safety at risk.
“Hospitals are full to bursting and left without enough staff as waiting lists soar,” he said.
“Half of nurses say their ward is dangerously understaffed and the majority of NHS staff believe the government’s reorganisation is harming patient care,” he added.
Repeating a pledge made by party leader Ed Miliband last month, Mr Reed said Labour would invest an extra £2.5bn to recruit 20,000 more nurses, which he claimed was an “investment the Tories will not match”.