The results of a new BMA report reveal the existence of widespread fears of unsafe care and a culture of blame
The BMA has published the first phase of a major project – Caring Supportive, Collaborative – aimed at finding solutions to the challenges faced by the NHS. The project was created to engage doctors in an open conversation about the future of the NHS and make real change.
Over recent months, almost 8,000 doctors have provided their accounts of working life across the NHS in a major survey conducted by ICM on behalf of the BMA; the results show the damaging impact of asking doctors to provide care without enough funding or resources to meet the needs of patients.
The results also show that poor lines of communication and organisational divisions between general practice and hospitals is undermining patient care. A lack of IT support is part of the problem, holding back collaboration and innovation.
Doctors are increasingly expected to provide patient care in unsafe environments, where a persistent culture of blame stifles learning and discourages innovation. Respondents to the survey believe patient services have worsened and national targets are prioritised over the quality of care.
This is contributing to a vicious cycle of low morale, according to the report, with doctors leaving the NHS in droves while the NHS struggles to replace them.
Chair of the BMA, Dr Chaand Nagpaul, conceived the idea for this project. He said:
“It is vital that the government and policy makers heed the views of all doctors who provide care at the coalface; they are in the best place to know the problems the NHS faces on a daily, hourly basis. They know the scale of impoverishment in the NHS is staggering. They are working in a culture which has improved little since the publication of the Francis and Berwick reports following the tragedies in mid-Staffordshire five years ago.
“Doctors experience challenges of trying to provide safe patient care when there is poor staffing, gaps in rotas, lack of adequate facilities and where a persistent culture of blame stifles learning and improvement.
“The BMA’s Caring, Supportive, Collaborative project aims to understand and find solutions to these challenges. “
As well as a culture of fear and blame, the survey also showed that black and Asian minority ethnic (BAME) doctors remain disadvantaged by the NHS, with only half feeling respected or culturally included in their place of work.
“BAME doctors make up more than a third of the medical workforce and play a vital role, day in day out, delivering care to patients across the country. Yet despite their commitment they’re more likely to face referral to the General Medical Council, are more likely to have their cases investigated and are more likely to face harsh sanctions following an investigation. Only 7 per cent of very senior managers are from BAME backgrounds.
“BAME staff in the NHS workforce as a whole are more likely to experience bullying, harassment or abuse from other staff. Differential achievement in exams and poorer career progression are another worrying factor, and with independent research showing that this is not related to any lack of ability. In the 21st Century, that is not acceptable.”