Patient safety at risk as physicians firefighting Titanic failings

Almost three-quarters of physicians are concerned that they will not be able to deliver safe patient care in the next 12 months, as staff warned they felt like “they were on the Titanic”, struggling to run care on shoe-string budgets, a survey by the Royal College of Physicians (RCP) has revealed.

Major concerns were also raised that staff were not aware of the freedom to speak up whistleblowing guardian, as only one in five surveyed said they knew who their guardian was, while less than a third believed that the guardians had improved transparency surrounding raising concerns about their organisation.

The survey asked 2,100 members of the RCP a range of questions about staff experiences delivering healthcare, and how confident they were in their capacity to raise concerns about patient safety.

The results are the latest in a range of studies that have found that frontline care is desperately underfunded, understaffed, and sinking under enormous pressure from an increase in demand for services.

A total of 78% of physicians said that demand for their service was rising, and over half felt that patient safety had deteriorated, whilst a third added that the quality of care patients were receiving had gone down.

Doctors were also asked to make comments about their work environments, with some describing their situation as “firefighting”, “papering over the cracks”, “hanging on by their claws”, whilst one member of staff even compared working for the NHS to being aboard the sinking Titanic – a sentiment that echoed an anecdotal survey the RCP reported last month.

In a speech at the RCP annual conference in Manchester today, RCP president Professor Jane Dacre said: “I am sure these figures will not come as a surprise to anyone in the room. The physicians I know, and I include myself, are optimistic, positive, can-do people who produce work round solutions to intransigent problems. 

“However, they are being pushed to their limits and no longer are optimistic about the future.”

Prof Dacre added that the RCP were worried about inherent safety risks in a hospital running at full or over capacity – coming from an increase in hospital-acquired infections to the impact of burnout from overworked staff: “Doctors and other staff need to know how to raise and escalate safety concern.”

Staff not flagging up issues about patient safety was also highlighted as a major issue, as Prof Dacre said: “NHS staff should feel empowered to bring legitimate concerns over patient safety – the evidence shows that where this happens, patient safety incidents decrease.”

A separate survey also published today by RCP about the workforce went some way to explaining why healthcare providers were struggling. This survey, which was taken in January, looked into workplace vacancies and found that 52% of respondents reported a vacancy in their department that month, while 31% had two vacancies and 25% had three or more.

Over half (58%) of posts were also found to have been advertised more than once. The results suggested that “workaround solutions” for missing colleagues was turning into “an ongoing problem rather than an intermittent issue”.

RCP director of medical workforce Dr Harriet Gordon said: “Workforce vacancies have become normal for some years now and given the trainee vacancies, are likely to continue. 

“Consultants are delivering patient care, but at the expense of other aspects of their role like management and training the next generation of doctors.’

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