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NHS waiting time targets 'will cause another Mid-Staffs'

By Nigel Praities

Ministers have damaged patient care and are risking another large-scale hospital safety scandal by pushing ahead with NHS targets on waiting times, claim a series of strongly-worded editorials published today.

Written by current and former GPs and consultants, the articles in the International Journal of Clinical Practice claim hospital targets distort clinical care and will lead to ‘another Mid-Staffordshire'.

They also say problems with the continued adherence to targets – such as the 18 week referral-to-treatment target – have resulted in less flexibility to accommodate emergency cases.

Referral management schemes had resulted in dangerous delays in patients with cancer getting through the system and NHS managers were unconcerned about emergency cases being delayed ‘because they breached no target', claims one doctor.

Mr Richard Spicer, retired consultant paediatric surgeon at the Royal Hospital for Sick Children, Bristol, says the ‘tyranny of targets' was a threat to the ethos of the NHS.

‘None of the targets I mention above actually helped any of my patients, and many patients were harmed by them,' he said.

'Recent events in hospitals in Stafford demonstrate what happens when managers are obsessed with meeting targets in pursuit of Foundation Trust status to the exclusion of the needs of patients and quality of care.'

'They tick all the boxes required by government, yet serious clinical deficiencies and avoidable deaths occur; 400–1200 excess deaths in the case of Stafford.'

In an accompanying paper, Dr Rubin Minhas, GP researcher at the RAND Corporation in the USA, says only a move away from targets and returned focus on patient care can restore confidence in the NHS.

‘The most important thing is a sea change in the target culture in the NHS so that real patients are centre stage, with people recognised and respected as individuals rather than as members of a population and the role of targets relegated to reflecting part of the picture rather than the entire picture,' he says.

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