Damning verdict on NHS targets
They are bad for morale, warns nursing union
nHS targets have damaged the morale of doctors and left other services starved of money, a nursing union has said.
The Royal College of nursing (RCn) has called for a reappraisal of waiting times targets in hospitals – nicknamed ‘P45 targets’ by staff who fear failing to meet them may cost their jobs.
The RCn said targets, such as the four-hour A&e waiting time, can result in money being poured into emergency departments without focusing on the root cause of problems – for example, funding for GP surgeries that could keep people out of hospital.
It claimed such targets ‘dominate’ debates on the nHS but do not take account of the personal experiences of patients.
The RCn report, Measuring Success, follows this week’s announcement by Health Secretary Shona Robison that the Scottish Government is reviewing its 19 healthcare targets.
The review, which could see some of the targets scrapped or tweaked, has been criticised as a ‘white flag’ after the SnP failed to achieve almost half of them. But a fresh look at the targets has been welcomed by the RCn and the BMA.
In the RCn report, Scotland director Theresa Fyffe said: ‘The current approach to setting and reporting on national targets and measures, while having initially delivered some real improvements, is now creating an unsustainable culture that pervades the nHS.
‘It is often skewing clinical priorities, wasting resources and focusing energy on too many of the wrong things.’
While refusing to give a ‘tickbox list’ of which targets to drop, the RCn report said the nHS should prioritise patients’ personal outcomes.
The targets the Scottish Government review will examine include the 62-day limit for cancer patients referred urgently by their GP for treatment, which was missed for eight out of ten types of cancer in the last three months of 2015.
Also under scrutiny will be hospital superbug rates, the 12week guarantee for patients to get treatment after it is agreed, and the four hours within which A&e patients should be found a bed, transferred or sent home.
The RCn report said: ‘The problem comes when the focus of the target becomes narrow and both investment and attention concentrate on the problem, not the cause, of the issue that requires a resolution.’
Last night, BMA Scotland chairman Dr Peter Bennie said: ‘Doctors are frustrated that the focus on political priorities the target system creates can overshadow clinical advice and decision-making.’
Miss Robison said targets had played a vital role but added: ‘As we enter a new parliamentary term, the time is right to take stock of what we are asking from the nHS to ensure our approach is consistent with improving outcomes for patients and shifting the delivery of care from hospitals to the community.’