Thursday 18 October 2007

Healthcare Commission report to save Johnson's bacon?

The Healthcare Commission today released its annual report, giving its performance ratings for all NHS Trusts in England. This is the most comprehensive assessment of the NHS’s performance on a local level, and is the second such report following last year’s analysis.

The scale of analysis for the 394 local Trusts was on the basis of two ratings on a four point scale, first for quality of resources and the second on financial management. Out of the 394 local Trusts, 16% were rated as "excellent", with a further 30% awarded a "good" rating on the first quality of resources test. This higher-category total of 46% represents an increase of 5% following last year’s report which rated 41% as achieving this standard. On the negative side, 45% were rated as "fair" and a 8% were rated as "weak". However, the overall report showed that the combined numbers in both lower categories fell from 59 to 53%. In the second test for financial management, 14% of Trusts were rated as “Excellent”, 23% “Good”, 36% “Fair” and 26% “Weak”.

In total, one in three trusts improved on their rating for clinical standards and a similar number did so for financial management, providing welcome news for the the Government following the hospital infection scandals in the Maidstone and Tunbridge Wells, and the Stoke Mandeville NHS Trusts. Referring to the recent hospital scandals, Health Secretary Alan Johnson has promised tough action on those trusts deemed to be failing patients.

Whilst Johnson will clearly attempt to use the report as a get-out-of-jail-free card to divert attention from the recent hospital infection scandals, frontline NHS staff will know the full extent to which other issues – such as hospital cleanliness – have been put aside in favour of balancing the books. For example, nurses writing on the blog Dr Rant ( have gone so far as to suggest that the 90 Maidstone patients whose deaths have been linked with the infection epidemic were sacrificed “to save Patricia Hewitt’s career”, following her assurance that she would balance the books or resign. One professional made the following points of how both patient care and hospital funds were cut back to meet the Government targets:

- Most days there isn't sufficient clean linen.
- There are nights when there is only one nurse for eight patients.
- There are nights when there is only 1 staff nurse and 1 Grade A nursing assistant, both male, for 18 patients, 2/3 female, a good percentage elderly.
- There are nights when there are 2 nurses 'specialling' and 1 A Grade nursing assistant for 18 patients.
- The buzzers ring for bedpans, commodes, general lavatory assistance all night. There aren't enough staff to meet the needs of the patients. Beds are soiled, and then, of course, need to be changed, providing there are clean sheets.

“All an unnecessary waste of resources, and an appalling loss of dignity to the patients. Managers kept their heads down and did nothing to resist. They knew what would the result of the cost cutting would be and went along with it to keep their jobs”.

Hardly a ringing endorsement of for Gordon Brown’s determination to retain centrally-imposed targets in the NHS – in the case of Maidstone, no wonder local MP Ann Widdecombe declared that she would be unwilling to send her own mother to Maidstone hospital, such was the level to which cleanliness had been ignored in favour of meeting these absurd non-sequiter goals.

Let’s hope that Andrew Lansley continues to put the punches in on Johnson and this disgraceful Government, who play numbers games with the health and livelihoods of patients.

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