NHS Culture Attacked by CQC Chairman David Prior

3 February 2014

NHS Culture Attacked by CQC Chairman David Prior

In a scathing attack on NHS culture, Care Quality Commission (CQC) Chairman David Prior has warned of “serious change” required within its care improvement standards to ensure patient safety is not further jeopardised. Prior stated that he was “shocked” by the behaviour he had seen, particularly alarmed by the friction between managers and clinicians which was holding back the NHS from improving its patient care standards.

Whilst the NHS has been dealing with a number of harmful scandals over recent years, with an inquiry last year into Stafford Hospital being the most revealing, Mr Prior is shocked that these harsh lessons do not seem to have been learnt by the NHS. While he admitted in his written piece in the Sunday Telegraph that he “loved” the NHS, he also added that it was vital its faults were highlighted and accounted for in order to force through change and highlight when things went wrong. The consequences, he wrote, could push the NHS into bankruptcy if they did not face up to the problems now.

Mistreatment.com often hears from members of the public who commence medical negligence claims about the poor standard of care they receive, often worried about the lack of transparency and accountability at the different trusts and hospitals they visit. A common theme that echoes through all of these claims is a need to be listened to and to have the ability to raise concerns when things go wrong.

“Shocked By The Behaviour I See”

Mr Prior said: "Parts of the NHS have developed a culture that doesn't listen - or worse, that stigmatises and ostracises those who raise concerns or complaints.

"Too often, it delights in the ritual humiliation of those deemed to fail, tolerates and institutionalises outdated working practices and old-fashioned hierarchies, and can almost encourage 'managers' and 'clinicians' to occupy opposing camps."

He said he "loved" the NHS "and yet am too often shocked by some of the behaviour I see".

Mr Prior reiterated that change was necessary and urgent with the UK doing well to emulate the systems used by organisations in the US which were fostering a culture of being “open” and “constantly learning”.

Mr Prior called for successful hospitals to take over hospitals and community services which were failing, better care outside hospitals, and for larger "centres of excellence" with savings from shared services such as radiology and pathology labs.

"Without serious change, the NHS will deliver poor care, and ultimately go bust," he said.

The need for accountability was a major recommendation in light of The Francis Inquiry-highlighting the many faults under the Stafford Trust-and this was also echoed by Mr Prior who said the ways the NHS was held to account when things went wrong required swift change. He said that trusts were too focused on waiting time targets and were “blindsided” by them and thereby failing to realise more pressing priorities.

“Process comes before humans”

Katherine Murphy, chief executive of the Patients Association, agreed with Mr Prior.

She said: "There is a culture in the NHS where process comes before humans.

"For years we've tried to highlight concern about poor care. We're often seen as a nuisance for highlighting these issues.

"The behaviour and culture that was allowed to grow in Mid Staffordshire is no different from that in many trusts in many parts of the country today."

Julie Bailey, of campaign group Cure the NHS said: "We have to face up that the NHS is in a crisis. We need to do something about it. I sat through every day of the public inquiry and that's exactly what came out. The NHS doesn't belong to the public any more.

"There's something badly wrong with the culture of the NHS."

Dr Mark Porter, chairman of the BMA Council, said Mr Prior's opinions were exactly in line with the frustrations expressed by doctors who had raised concerns with them about issues prevalent in their own hospitals.

"At Mid Staffordshire we saw how patient safety can suffer because of a combination of managerial obsessions and disengaged and disillusioned clinical staff," he said.

"We can no longer tolerate managers and clinicians seeing themselves as being on opposing sides. Only by stepping out of our traditional roles can we ensure that patients continue to receive the excellent care they deserve."

“Focusing on poor care like never before”

The Department of Health said it was "focusing on poor care like never before" and had turned around "14 hospitals that are in special measures".

A spokesman said: "We are clear that targets must never come before clinical need - and based on clinical advice, we have scrapped a number of them.

"However, it's right that patients have certainty about how long they can expect to wait for medical treatment when they are ill.

"In fact, despite the NHS treating more people than ever waiting times are low and stable and there are 35,000 fewer patients waiting longer than 18 weeks than in May 2010."

Mistreatment.com was created to listen to talk to people who feel that they had nobody at the NHS to listen to them when something went wrong. Members of the public who call through to us often want to raise an issue within NHS care so that somebody else is not affected the way their and their loved ones have been. Sometimes they call through to us to make a medical negligence claim because a financial settlement is needed to rebuild their life and to take care of their family. If you have experienced a form of medical mistreatment through emergency services, A&E or through surgery, for example, you can speak to the experts at Mistreatment.com