THE BLOG

Why NHS Red Tape Is Making Another Stafford Hospital Scandal More Likely

20/02/2014 14:07 GMT | Updated 21/04/2014 10:59 BST

It's a year since the findings of the public inquiry into the Stafford Hospital scandal were published. Yet still the ghosts of what happened there refuse to rest.

The £13 million inquiry, which was the fifth major investigation into what went wrong in Stafford, produced an 1800-page report that made no fewer than 290 recommendations.

No-one could accuse the man who led the inquiry, Robert Francis QC, of not being thorough.

The NHS Trust which presided over the tragedy - which saw as many as 1200 patients die as a result of poor care in four years - is now being formally dissolved.

Mid Staffordshire NHS Trust had become a byword for the institutional mistreatment of patients. Accounts of patients left to fester in their own urine by nurses, and others who were given so little water that they were forced to drink from flower vases, are hard to forget.

But the Trust's ignominious end is just a footnote among a series of new blunders and scandals to emerge in the NHS last year. Last summer a further 14 hospitals with the highest death rates were censured for failings in their care.

Police are currently investigating reports that staff at Colchester Hospital were bullied into falsifying data about cancer patient waiting times in order to meet national targets.

Never again - if only it were so easy

Each time a new scandal is uncovered, NHS managers wring their hands and vow "lessons must be learned", and that steps will be taken to ensure nothing like it can ever happen again.

Though the sheer scale of the problems at Mid Staffs was unique - care standards all but collapsed and some patients were left crying out for help after being given no pain relief - the factors that caused them have often been found elsewhere in the NHS.

Cost-cutting and target-chasing can leave medical professionals dangerously overstretched, and it is in this environment that mistakes can be more easily made.

While the Stafford Hospital inquiry made some valid recommendations - for example the creation of a statutory obligation on doctors and nurses to be open with patients about mistakes - there is a danger that the implementation of ever more "codes of conduct" can do more harm than good.

All too often these codes of conduct create new layers of bureaucracy for front-line medical staff.

How red tape can strangle good care

The reality is the more forms doctors and nurses have to fill in, the more boxes they have to tick, the less time they have to spend caring for patients. While it's only right to expect our medical professionals to follow best practice and be accountable for their work, tying them up with excessive form-filling doesn't help.

Research by Oxford University suggests that by piling more rules-based regulation onto NHS staff, we risk making them lose sight of the values-based self-regulation that broke down so badly at Mid Staffs.

While the NHS is full of dedicated and hard-working professionals, the medical profession everywhere is under rising pressure in terms of time, cost and bureaucracy. Doctors and nurses are human, and fallible. Mistakes will happen, but time pressure and extra red tape must not be allowed to make them more common.

Too much bureaucracy and form-filling will make a repeat of the Mid Staffs scandal more likely if it distracts doctors and nurses from the vocation that attracted them to medicine in the first place.