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Scotland’s own Mid Staffordshire scandal is possible

RCP Edinburgh says culture change vital to prevent other scandals

Adrian O'Dowd

Monday, 25 February 2013

A scandal of the scale seen at Mid Staffordshire NHS Foundation Trust is possible in Scotland if action is not taken to make deep-rooted cultural change, according to the Royal College of Physicians of Edinburgh (RCPE).

In an editorial published online today in the college’s Journal of the Royal College of Physicians of Edinburgh, its leaders outline how the medical profession should respond to the recent Francis report on what went wrong at Mid Staffs.

The editorial, written jointly by Dr Neil Dewhurst, college president, and vice presidents Dr Mike Jones and Dr John Alasdair Wilson, said: “Let us be under no illusion that the problems encountered in Mid Staffordshire were a localised, or isolated, happening. The contributing circumstances have the potential for this to occur in any hospital under pressure, and leave no room for complacency.

“We emphatically agree that the lessons learned here are too important to ignore, must be acted upon and result in cultural change to avoid repetition.”

One of the steps the college had already decided to take in response to the Francis report was to start developing a confidential standards “hotline” through which fellows and members of the college who had witnessed poor quality care that was resistant to local change could raise concerns.

Fellows and members in the UK will also be encouraged to complete an RCPE survey regarding standards of care and reporting mechanisms.

There were many problems faced in the NHS and by doctors involved in providing acute medical care in hospitals, they said, and these had been growing over a number of years and were interconnected.

Problems included the rapid rotation of trainees through the specialties, while working shifts and plugging rota gaps, which had eroded the concept of medical teams, and the European Working Time Regulations along with a run-through training policy that had limited the number of available medical registrars.

Other factors included the increasing unpopularity of the acute medical take, the steady loss to other specialties such as general practice and radiology and other countries as well as the reduced presence of GP out of hours and increasing numbers of medical admissions at the same time as a reduction in acute hospital beds.

The editorial adds: “The need for strong medical leadership has never been greater. We believe the NHS has lost its focus, that now is the time for the NHS to re-commit to the central importance of high quality care and to foster a culture in which the delivery of this care is placed above all else.

“We will work with other stakeholders to ensure that there is greater transparency about standards of care, that doctors are encouraged and supported in raising legitimate concerns about poor standards of care and that these concerns will be shared with the appropriate bodies.”

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