‘Don’t put targets ahead of patient care’

March 22, 2010, 8:29 PM GMT+0

The considerable majority (77%) of the British people believe that the Government’s introduction of targets for GPs and hospitals often leads to a reduced emphasis on patient care, a new survey undertaken for the Sun has revealed.

The result follows a recent review by independent auditors of the Queen’s Medical Centre which concluded that staff at a Nottingham hospital ‘bent rules’ on recording patient waiting times because ‘some staff described the enormous pressures they felt under to achieve the four-hour A&E target and deliver patient care at the same time.’ The audit found 1,889 records had been wrongly recorded since April 2008.

The debate over target setting is closely related to the recent criticisms surrounding incentive based medicine and the Quality and Outcomes Framework (QOF) has been condemned for offering inappropriate financial incentives that can distract GPs from providing high quality personalised care for patients.

When asked to choose the three biggest problems with the NHS today, 41% of Brits cited ‘postcode rationing of drugs’ (where drugs are available in some areas but not others) as a key issue. Other priority issues were ‘cleanliness of wards’ at 39%, ‘superbugs or MRSA’ at 38%, and ‘poor standards of care for elderly patients’ at 37%. Despite receiving media attention in recent years, issues such as ‘waiting times for operations’ (27%), ‘mixed sex wards’ (16%) and ‘shortage of midwives’ (15%) didn’t fare too badly. Interestingly, only 15% cited ‘A & E waiting times’ as a big problem, but ‘putting targets ahead of patient care’ came top at a relatively large 63%.

What our result indicates is that the British public view patient care as a sine qua non. If a conflict arises between reaching targets and patient beneficence, the public would rather have GPs delivering the highest levels of patient care as opposed to what the retired academic, director and writer Raymond Tallis has termed ‘sessional functionaries robotically following guidelines’ – one interpretation of what happens when targets are seen to be of a higher priority than patient care.

For survey details and full results, please click here