DR DAVID BAILEY
COLUMNIST
DOCTORS are facing increased pressures. Cuts to the NHS squeeze medical staff to breaking point and vacancies continue to climb. We don’t have enough doctors to fill rota gaps and the inevitable knock-on effect will be a drop in standards of care for patients. Wales has an opportunity to help lead the way on safe staffing levels with the current Quality and Engagement Bill, and we need to grasp it with both hands.
The Welsh Government is currently working on the first stage of the Quality and Engagement Bill, and it does go some way to tackling widespread issues across Welsh NHS organisations. It proposes a duty on organisations to be open and honest when things go wrong, allows Welsh ministers to appoint vice-chairs to the boards of NHS trusts and it would mean that Welsh ministers, local health boards, NHS trusts and special health authorities all have to work to secure quality in health services. However, despite this progress, there remain gaping holes around staffing levels.
Research has shown us, and common sense suggests, that there is a clear link between the level of quality that can be delivered by a hospital and whether that hospital has an appropriate number of staff available, but this isn’t acknowledged by the Bill. Understaffed hospitals contribute to adverse outcomes and have been a strain on our health service for too long. As doctors, we feel this pressure keenly and have been taking on extra shifts in the hope of plugging institutional gaps, but we need legislation that goes further and enshrines safe staffing in law.
Contrast Wales with Scotland, where this year the Health and Care (Staffing) (Scotland) Act 2019 explicitly says that one of the main purposes of staffing for healthcare and care services is to provide safe and high-quality services. This has been acknowledged across past pieces of legislation within Wales in relation to nurse staffing levels in certain settings, and we strongly commend this pioneering work in the Nurse Staffing Levels (Wales) Act 2016.
The Act helped address a raft of failings that independent reports had drawn attention to, and enshrined patient safety as the first concern in hospitals, but if the Welsh Government misses its chance to bring other medical professionals under this same umbrella, it would be making a grave mistake.
Wales is in danger of lagging behind other parts of the UK unless we take this step. The Bill must be used to extend the Nurse Staffing Levels (Wales) Act 2016 to other healthcare staff. This would put a duty on NHS bodies to ensure appropriate staffing and to have real-time staffing assessments in place to make sure wards are always manned with the right number of staff, who are able to deliver the highest possible quality of care.
As doctors, delivering the best possible care to the people of Wales safely is our highest priority. As a patient, you should feel confident that the quality of care you’re going to receive is both high and consistent throughout your stay. For too long, lacklustre staffing levels have turned this into a question mark. The time to take action is now.
■ Dr David Bailey, chair of the British Medical Association’s Welsh Council