The culture of the NHS has yet to catch up with the rhetoric as this speech from the GPC leader underlines.
This article from 2001 sets out how the “Culture of blame” was to end in the NHS , however the blame culture is now stronger than ever and it inhibits progress in patient safety .
Seven pledges of new joint document on NHS ( BMJ. 2001 Jul 7; 323(7303): 9.)
To continue to show a commitment from the top to implementing the programme of quality assurance and quality improvement
To take every opportunity to involve patients and their representatives in decisions about their own care and in the planning and design of services
To work towards providing valid, reliable, up to date information on the quality of health services
To work together in determining clinical priorities
To create a culture in the NHS that is open and participative, where learning and evaluation are prominent, and which recognises safety and the needs of patients as paramount
To recognise that in a service as large and complex as the NHS things will sometimes go wrong. Without lessening commitment to safety and public accountability of services, the signatories pledge to recognise that honest failure should not be responded to primarily by blame and retribution, but by learning and by a drive to reduce risk for future patients
To recognise that the professions, the government, and the public share a common interest and commitment to improving the quality of services for patients
The King’s Fund also tries hard to help the NHS to change …. but it would seem that all attempts thus far have proved futile
GPs operating in an ‘unforgiving climate of blame’, says GPC leader in defiant speech
GPs are operating in an ‘unforgiving climate of blame’ through having to deal with pressure from litigation and the CQC while tackling ‘unsafe’ workloads, GPC chair Dr Chaand Nagpaul will say in a speech to the BMA’s annual conference.
Addressing doctors from across specialties at the BMA’s Annual Representatives Meeting in Belfast, Dr Chaand Nagpaul will say that ‘pressures on general practice have sunk to new depths’ since last year’s meeting.
He will promise that GPs will fight every day to resurrect their ‘proud profession’ and highlight the fact that at the LMCs Conference in May, GP leaders gave the Government three months to accept the recommendations in the GPC’s Urgent Prescription for General Practiceor they would canvass the profession on its willingness to submit undated resignations.
Dr Nagpaul will lament the ‘explicit wholesale transfer of care out of hospital’ which ‘continues unabated’.
He will raise troubling statistics, including:
- ’70m more patients seeing us annually compared to seven years ago and with fewer GPs per head which is drowning our capacity to cope.’
- ‘A record 201 surgeries closed last year – the tip of a much larger iceberg of practices on a cliff edge.’ (This is actually from a Pulse investigation which showed there were 201 fewer surgeries, although many had merged, not closed)
- ‘Unfilled GP vacancies are at their highest, with half of practices struggling to recruit locums to provide essential services.’
He will say that all of this combined ‘has led to a toxic mix from which existing GPs can’t wait to escape, and which many young doctors will not join’.
Dr Nagpaul will add: ‘Far from the being thanked for working against all odds, there’s an unforgiving climate of blame. Litigation against GPs has rocketed, no doubt contributed to by us not being able to work safely. CQC adds further insult by crudely judging practices rather than recognising our impossible context.
‘How callous to name and shame practices for not having the capacity to tick boxes when those struggling the most are rightly spending their time attending to patients rather than producing