Pearson Hinchliffe Solicitors - Professional Understanding - Advising - Supporting - Delivering

Surgeons say targets endanger patient safety

A study into NHS surgeons’ attitudes reveals pressures over hospital budgets and targets may be damaging safety in operations.

A survey of surgeons suggests pressures to meet targets may be putting patients at risk. One in five of those who took part reported being involved in an incident in which a patient was harmed during a two week period in 2009. Many complained of having to operate on patients they had not seen before and not having enough time for more complicated procedures. 

For many years governments have told the NHS to make patient safety its top priority. But this survey, conducted by Bournemouth University, suggests that many surgeons are unhappy with the safety culture. 

The government says "a culture of micromanagement" has endangered safety.

Patients being harmed

This is considerably higher than the figure cited by the UK National Patient Safety Agency, but lower than those from similar studies done in the US.Nearly 600 general surgeons responded to the confidential online questionnaire - about one in 4 of the members of the Association of Surgeons of Great Britain and Ireland. Of these 40% said they had been involved in an untoward event where a patient was nearly harmed and a further 20% where there was actual harm during the two week period covered by the survey. The findings published in the Annals of the Royal College of Surgeons estimate that about 3% of operations were affected.

Management pressure

When asked about what gets in the way of patient safety many surgeons said they did not feel in full clinical control because of pressure from managers to get through operating lists. The Royal College of Surgeons says that the figures should be set in the context of the vast number of operations that are carried out, the great majority with a very satisfactory outcome.

Warning against bowing to pressure from managers one surgeon was quoted in the paper saying, "Don't be seduced by management into making do, thinking you are being heroic; you're not, you are being dangerous."

The lead author, Professor Colin Pritchard from the School of Health and Social Care at Bournemouth University, says surgeons often come under pressure to "slip in" extra patients on their lists.

"If anything goes wrong they're responsible but not in charge. The key is the influence - and often the malign influence - of managers who are concerned with meeting targets."

However, he says, the surgeons are "very understanding" of the pressures faced by managers, who he says are forced to look at patients as "numbers or nuts and bolts".

Pearson Hinchliffe Medical Negligence Partner John Pollitt commented on the study saying: “This is an alarming report. Whenever possible all care must be taken to ensure that the patient is properly prepared for theatre and that the procedure is carefully planned. It has been proven time and again that by failing to plan a surgeon is planning to fail.  I can well understand why surgeons (who innately want to help) would accommodate management requests to ‘slip cases in’.  If targets are imposed resources must be made available to ensure that they are safely complied with”.