latest health care news

15.02.17

Threat of hospital closures ‘counterproductive’ to imposing weekend working

The threat of closure to emergency and maternity services from the London Quality Standard (LQS) is “counterproductive” and has not achieved its aim of reducing weekend deaths in NHS hospitals, a report released by the Nuffield Trust has revealed.

The think tank’s findings also warn that it would be a mistake to use the seven-day standards as a basis for deciding to close or downgrade hospital services.

The report into LQS, the London precursor to the Seven-Day Services Standards being incorporated into nationwide health plans, found that standards proved to be successful in places where there was high engagement from clinicians, but that there was no evidence the programme improved weekend mortality rates or discharge rates compared to the rest of the country.

Engagement was also found to “evaporate” when the threat of closure or downgrading of hospitals was used as a “stick” to enforce clinicians to adhere to standards.

The Nuffield Trust reviewed the 21 standards for acute medicine and found that by successfully engaging with frontline clinicians and managers, standards were improved.

Half of the organisations questioned for the organisation’s report also revealed that standards led to major change and improved care for patients by raising safety standards and enforcing better standards in staff procedure.

Dr Louella Vaughan, Fellow in health policy at the think tank, argued that the report should act as a “warning sign” to those involved in the STPs being put in place across the country.

“Many of these [STPs] imply that the ability to comply with national seven-day standards – the successor to the LQS – will influence which hospitals stay open,” she added. “Our research shows that using standards in this way would be a serious mistake. Not only could it harm crucial working relationships between doctors and managers, but it could mean major decisions being made on evidence not strong enough to justify them.”

Earlier this month, the Royal College of Emergency Medicine criticised proposals within STPs of reconfiguring emergency departments as an option for long-term change, calling the approach “alarming”.

The BMA has also published an investigation which found that almost £10bn of fresh money will be needed upfront to finance the projects put forward in 36 of the 44 draft plans. Its council chair, Dr Mark Porter, argued the programme was “doomed to failure all along owing to inadequate funding and a lack of political will to transform services properly”.

This built on previous remarks from the union that STPs will put the NHS at risk of drastic service closures, with Dr Porter again warning that the NHS needed an urgent cash injection to continue operating in the meantime.

The Nuffield Trust’s latest report was drawn up from a year-long project into LQS, using seminars and focus groups from those who developed the standards as well as by engaging with frontline staff tasked with implementing the standards.  

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