Is naming and shaming the way to improve patient safety?

Last week Health Service Journal announced that unsafe hospital trusts are to be ‘named and shamed’ online if they do not comply with patient safety alerts. But is this really the best approach to take in improving patient safety?

Patient safety alerts are issued when potentially harmful situations are identified in healthcare organisations.  Alerts are an important part of the work that NHS England undertake in warning the healthcare system of risks and providing guidance to avoid potential incidents that may lead to serious harm or death. But will publicising such alerts just contribute to the negative view of our healthcare system that many already have.

With numerous government reports and high profile figures, including the health secretary Jeremy Hunt, blaming a lack of compassion from staff as the cause of many patient safety failures, it seems that constant negative publicity has resulted in staff and trusts being caught in a vicious circle – negativity breeding more negativity. It is often easy to forget that despite all of the negative publicity towards NHS trusts, the majority of healthcare staff will continue to provide excellent patient care.

This week marks a year since the publication of the Francis report, which examined the causes of the failings in care at Mid Staffordshire NHS Foundation Trust between 2005 and 2009. Among the key areas highlighted were the importance of openness, transparency and candour as well as improved support for compassionate, caring and committed care. The report sought to prioritise what practices needed urgent revision within the NHS as a whole. Whilst it may be perceived that the report led to unfair criticism of the nursing profession who were already struggling due to levels of staffing and underfunding, the real aim was to drive significant improvements in patient safety and care.

In the government’s response to the Francis report, measures were outlined calling for trusts to regularly publish details of staffing levels and encouraged the implementation of ideas like hourly ward rounds and supervisory status for ward managers.

Nursing Times recently carried out a survey to gather insight into the impact that the Francis report has had. The survey revealed that the current staffing on wards varies for nurses, with 39% of those asked warning that staffing levels have worsened at their place of work over the last 12 months. This truly highlights that it is unlikely to be lack of compassion that leads to failures in patient safety, but a lack of time.

Of the respondents to the survey, almost half believe that the Francis report will bring “long-term positive change for the quality of healthcare provision in the NHS”. Despite the negativity surrounding trusts such as Mid Staffs, there is no strong evidence that the standard of care in the NHS is deteriorating. However, the media focus continues to be negative.

Patients have the right to know about the standard of care that they will receive at their local hospital. This information allows them to make more informed decisions about where, when and who will be in charge of their care. The NHS is already addressing patient choice and transparency with schemes such as Choose and Book but is this enough and what more can be done? Blaming staff and publically discrediting hospital trusts will not improve care in the long term. Staff need to feel supported in their role and be assured that changes are being made at a local and national level which will help them improve the care of their patients.

With this new approach, we will no doubt end up publicly naming underfunded and understaffed providers who are trying desperately to function while striving for quality and safety at the same time as trying to balance the books. With the support of government funding, hospital trusts are continuing to improve in all aspects of patient care and safety. Perhaps the press need to focus on all of the improvements, which will lead to trusts aspiring to achieve more? Shaming trusts further will only light the fire of more negative media coverage.

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