Thursday, 14 February 2013

Third of NHS finance directors think quality of care is declining

Third of NHS finance directors think quality of care is declining: Findings of survey for King's Fund prompt fresh concern about how hospitals look after patients
Fears are growing in the NHS that quality of care experienced by patients is falling as the service struggles to cope with rising demand for treatment and tight budgets, a new survey reveals.

One in three finance directors of NHS organisations in England believes quality of care has worsened in the last year. Asked by the King's Fund health thinktank what had happened to the quality of patient care in their area in that time, 16 of the 48 said it had got worse, up from seven of 45 in the previous quarterly assessment last September, 26 said it had stayed the same and six said it had improved.
Coming a week after Robert Francis QC's damning report into the Mid Staffordshire hospital care scandal, the findings prompted fresh concern about how hospitals look after patients. Finance directors blame the coalition's NHS shake-up and an accompanying high turnover of senior staff for the apparent drop in care quality.
The NHS Confederation, which represents hospitals, endorsed the thinktank's warnings. "Despite huge efforts to maintain standards of care and finances, NHS leaders are increasingly concerned about the pressures mounting on their organisations and the knock-on impact of reductions in funding for local government services", said its chief executive, Mike Farrar.
The King's Fund also found that social care services are being affected by the spending squeeze. Almost half (27) of the 58 local council directors of adult social care it surveyed said care had declined in the last year, while 21 expected to cut services this year and 12 said they would have to increase charges for them. The NHS would not be able to maintain quality of care in the face of rising demand and growing financial pressures unless it urgently transformed how and where it cares for patients, Farrar added. He believes many more health services have to be delivered in or near people's homes, with an accompanying drop in the number of hospitals, to make the NHS sustainable in the long-term.
Earl Howe, the health minister, said: "We expect the NHS to look seriously at how it can improve how care is provided, particularly to older patients and those with long-term conditions."
However, the report also praises the NHS for maintaining the big falls in waiting times for hospital that were achieved under Labour in mid-2009 and "continuing impressive reductions" in hospital-acquired infections. But it also found that the proportion of emergency patients forced to wait beyond the four-hour target to be seen in A&E reached its highest level (4.3%) in the last quarter of 2012 since 2003-04 and that more than a quarter of hospital trusts (65) -- breached the government's target that 95% of them should be treated within that time.
Andy Burnham, the shadow health secretary, said the survey "provides clear evidence that England's health and social care system is heading in the wrong direction. Standards of care are deteriorating in many parts of the country as the NHS is dragged down by a toxic mix of cuts and re-organisation", he said.
Michelle Mitchell, charity director of Age UK, said the findings about social care made "very grim reading". Almost 830,000 older people who need care receive no formal support "meaning many of the most vulnerable in our society are having their dignity and safety compromised on a daily basis." Inadequate social care provision not only leaves older people more vulnerable and isolated but also costs the NHS money through avoidable hospital admissions, she added. The Guardian

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