Almost three-quarters (73 per cent) of NHS professionals do not think that quality of care in the NHS is given enough priority, says a survey published today in a new report on patient-centred leadership by The King's Fund. The survey, which took place after the publication of Robert Francis's report, also found that 40 per cent thought that the quality of leadership in the NHS as a whole was poor or very poor, in contrast to 11 per cent in their own service or team.
When asked what the biggest barrier to increasing quality of care was, 40 per cent of NHS professionals said 'time and/or resources', though this figure was higher among nurses (51 per cent). 'Organisational culture' was next (identified by 28 per cent of respondents), though it was identified as the most important factor by NHS executive directors (48 per cent).
The report concludes that nothing less than a transformation of systems, leadership and culture is needed throughout the NHS if the lessons of the Francis Inquiry are to be learnt and acted on. Alignment of leadership in clinical teams, NHS boards and national organisations around the needs of patients and quality and safety of care is essential.
The report confirms that care quality within NHS organisations is first and foremost a corporate responsibility under the leadership of boards. However, when asked who has the biggest impact on quality of care, NHS professionals ranked boards sixth out of eight, behind clinicians, managers, government, regulators and patients. This suggests that boards should be doing much more to exercise clear and visible leadership to improve the quality of care their organisations provide. Boards need to demonstrate that they give sufficient priority to quality and patient safety – for example, by seeking and acting on patient feedback, hearing patient stories, reviewing and learning from complaints, taking time to listen to patients and their relatives, and acting on the results of staff surveys.
To ensure that the failings in Mid Staffordshire do not re-occur, the report recommends that the leadership of the NHS at a national level needs to create the conditions in which high standards of care are delivered consistently, setting clear goals and standards for improving quality and patient safety, and providing the means for staff to deliver these goals within available resources.
Nicola Hartley, Director of Leadership Development at The King's Fund said:
'It's the responsibility of all NHS organisations and professionals to make care patient-centred – to put patients' needs above those of the organisation, team or profession. Our survey suggests that we have a long road to travel to achieve this. We know that most NHS staff are intrinsically motivated to help people who are at their most vulnerable. It is a failure of leadership if those staff consistently face barriers to treating patients and their families well.
'Leaders throughout the NHS, especially at board level, need to ensure that patient-centred care is core to the organisational culture. These kinds of changes do not occur by good intention; they require time and commitment from ward to board to achieve sustainable change.'
Notes to editors:
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This is the third annual leadership review carried out by The King's Fund. The report, Patient-Centred Leadership: Rediscovering our purpose, can be viewed using the following link: www.kingsfund.org.uk/leadershipreport
The survey is detailed in the appendix of the report. It was carried out in partnership with the Faculty of Medical, Leadership and Management; Managers in Partnership; the NHS Confederation; NHS Professionals; the Royal College of General Practitioners; the Royal College of Midwives; the Royal College of Nursing; and the Royal College of Physicians.
The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.