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Red tape and lack of capacity prevent NHS improvements, reveals new BMA survey

Readers of this blog will know that I have written recently from my own experience of  a deep malaise at the heart of the NHS The problems are not the result of a lack of compassion. They don't stem from inefficiency of staff per se. The problem is systemic. There is indeed a deep malaise at the heart of the NHS. It results from underfunding and a reorganisation that has produce chaos and a lack of joined up care. It results in large part from savage cuts that have impacted dramatically on front line care and the capacity of doctors to make a difference.

Now a new BMA survey, published today at the BMA's annual representative meeting (ARM) in Edinburgh, has revealed that red tape and a lack of capacity are preventing NHS improvements. Furthermore, the BMA warns, the NHS is at breaking point.

Two thirds of doctors (67%) say they wanted to make changes or improvements in the past year but were hindered by excessive red tape and lack of capacity or support.

Almost 1,000 doctors responded to the BMA’s UK-wide Omnibus survey which assessed their current attitudes to working in the NHS. Almost nine in ten (89%) doctors said they had faced barriers or obstacles when attempting to make changes or improvements.

The main barriers respondents describe include:
  • lack of time and capacity (51.3%) 
  • financial constraints (39.2%) 
  • insufficient managerial support (39%) 
  • too much bureaucracy (34%) 

Despite the Government’s pledge to rid the NHS of wasteful bureaucracy and give doctors more control, almost two thirds (65%) of doctors feel less empowered than they did a year ago and seven out of ten (70%) describe their experience at work as ‘worse’ or ‘much worse’ to this time last year. The vast majority (81%) describe work pressures as either ‘high’ or ‘very high’, with the top pressure being meeting patient activity levels. GPs are most likely (89%) to report very high or high levels of pressure.

Overall respondents were most likely to indicate being frustrated rather than encouraged and to have a more pessimistic than optimistic view towards working in the NHS. However doctors were more likely to give a more positive response towards enthusiasm or motivation.

As the NHS nears its 65th anniversary, doctors said the things needed to keep the NHS going for another 65 years were greater integration between health and social care (48%), better management of activity (44%) and less emphasis on competition (33%).

Commenting on the findings, Dr Mark Porter, Chair of BMA Council, said:

“Despite the huge and relentless pressures they face, many doctors remain enthusiastic and motivated about working in the NHS, and this is very heartening, but it is a grave cause for concern that those who wanted to make improvements to patient services feel there are barriers prohibiting that. It is particularly worrying that the pressures so many doctors are experiencing on a daily basis appear to be getting worse.

“The Government wants to give doctors more control so they can work effectively for their patients, yet they often find this impossible in the face of an unprecedented funding squeeze, inadequate staffing levels and rising patient demand. Instead of directing the blame towards individual parts of the health service when the NHS comes under pressure, we need the Government to work with staff, who see the pressures first hand, to help solve the problems. Doctors should be encouraged and supported, not burnt out and drowning in red tape.”

“If the NHS is to survive another 65 years there must be a clear recognition that we are reaching boiling point with patient demand. There must also be a greater focus on integrating health and social care, rather than the continuing obsession of having a competitive market in health.”

The NHS is sleepwalking to a disaster. It is disingenuous for the government to claim that a £20bn cut in the NHS budget could be made without affecting front line staff, doctors, nurses and vital technical support. The claim that 'streamlining' efficiency savings could be made without cuts in front line staff is wrong. The government knows this of course. But it doesn't stop them repeating the falsehood. Now the BMA survey reveals there is more red tape not less. Cuts and top down reorganisation has pushed the NHS to breaking point. It will take the government no time at all to destroy the NHS. It will takes decades to rebuild. 

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