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13.02.13

Box ticking ‘cannot be the solution’ – Hunt on Francis

There is too much unnecessary regulation and bureaucracy in the NHS, health secretary Jeremy Hunt has stated in his first public response to the Francis report.

The report made 290 recommendations, many of which would require new laws and regulations. Hunt said that foundation trusts currently have 60 different regulatory, licensing, commissioning and public scrutiny authorities that they must report to and comply with.

It was this “elephant trap” of bureaucracy that must be avoided and reduced, he said.

Nurses spend a fifth of their time on paperwork, much of it duplicated. Hunt announced his intention to try and reduce bureaucratic burdens by a third, and if more regulation must be added, it must be outweighed by others being taken away.

He announced that Mike Farrar, chief executive of the NHS Confederation, is to draw up a plan for how joint inspections and shared information can improve clinical outcomes and free up more time for care.

Hunt said: “A Chief Inspector will draw the multitudinous inspection regimes together and focus them on what is really important. It will put quality of care first, on a par – or even more important than – financial stability. If a hospital fails to deliver the level of care that we would expect, it will be put into a failure regime.

“At the moment, failure to meet CQC standards simply does not have enough consequences for the management of a hospital. Losing control of your finances matters – of course – but losing control of your care matters even more – and boards need to know that their jobs are on the line if they don’t sort out those problems.

“But as we make these changes, we must avoid a huge elephant trap: to think care and compassion can be commanded from on high either by regulators or politicians. Endless boxes to tick, cumbersome bureaucracy and burdensome regulations are a big part of the problem – they cannot be the solution.”

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Image c. DCMS

Comments

Jon   13/02/2013 at 15:16

I see no change yet in the top down micro-management by the NHS Commissioning Board but hope this will come. Although Francis stated there was no bullying culture in the NHS, over-zealous performance management certainly did exist. Some of those people and learned behaviours (bad parent / child relationships) are still around and will take time to change.

Sisyphus   13/02/2013 at 15:55

Every clinician in the NHS has been pointing out the hidden costs of over-management and over-regulation for decades now. Politicians and managers (obviously) have continued to ignore them. I have no doubt Jeremy Hunt will be no different. The CQC cannot be a part of the solution because it is part of the problem. The vast amounts of manpower and money poured into making NHS organisations compliant with the micro-management engendered by CQC (not to mention the myriad other regulatory bodies) has all had to come from patient care. The incredibly inefficient and expensive internal "market" has also been a massive drain on resources but is an article of faith for politicians including Jeremy Hunt. I predict there will be no change for the better.

Solent   14/02/2013 at 10:15

It's not just clinicians that have been highlighting over-regulation and micro-management. Many, many managers agree with this entirely. Also that the internal market is thoroughly counter-productive and incredibly wasteful. Those with medical training are not the sole custodians of wisdom in the NHS, and that "us and them" culture makes achieving anything far harder than it should be.

Ethel   15/02/2013 at 11:08

I am so pleased that the 'box ticking' is at last being discussed as an issue as a major part of the problem within the NHS at the present time.. Having worked in the front line of the the NHS for the past 25 years. I have witmessed, imlemented and experienced every change and mistake that has been made by the Governments of this coountry since 1990 'Ticking boxes' does not make for good patient care because it takes away the 'hands on' time and 'listening to the patients' time that is needed by clinicians and administartion staff to assess the real needs of the patient. The recent introduction of the CQC is time wasting and counter- productive- it is bureaucracy gone mad wasting more of the NHS money.

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