Target Culture Warning For NHS

Medical and nursing organisations have united to attack the "unsustainable culture'' of targets in the health service and call for urgent action to ensure it is fit for purpose.

A "bold and visionary'' approach is needed to bring about genuine change in the NHS, according to the Academy of Medical Royal Colleges and Faculties in Scotland and the Royal College of Nursing (RCN) Scotland.

The organisations said difficult decisions must be taken about how and where money is invested if the NHS is to be sustainable.

Health Secretary Shona Robison said she would listen carefully to the concerns raised but argued that much progress had been made.

Targets is one of four areas in which the health professionals say a new approach is needed.

A joint statement said: "The current approach to setting and reporting on national targets and measures, while having initially delivered some real improvements, is now creating an unsustainable culture that pervades the NHS.

"It is often skewing clinical priorities, wasting resources and focusing energy on too many of the wrong things.

"As a matter of urgency, there needs to be a more mature approach to how the NHS uses targets, standards and other performance measures to ensure better and sustainable outcomes across the health service.''

The royal colleges also called for a "frank debate'' about the pressures the health service is under, new models for delivering care to ease pressure on hospitals and improved collaboration between health professions.

"The time for talking and political point-scoring has passed. We need to take practical action, together, now,'' the statement said.

RCN Scotland director Theresa Fyffe said: "Tinkering around the edges and simply putting more and more money into the current system is not the answer.

"We know we cannot continue to deliver services the way we have done up to now and it is up to us, as professional leaders who share a collective aim and represent health professionals working on the frontline, to step forward and take a leading role in kick-starting the public debate that needs to take place about the future of our NHS.

"Without change now, we're putting at risk the sustainability of our NHS.''

Academy chair Ian Ritchie said: "We're seeing day in, day out the immense pressure which the NHS is under as patient demand and public expectations soar, and funding is unable to keep up, even with increases in the NHS budget.

"We know that the way services are delivered has not kept up with the advances in patient care and treatment.

"What we require, urgently, is to develop new models of care which are fit for the future.''

Dr Peter Bennie, chair of the BMA in Scotland, said: "There is no doubt that the service is struggling to cope with rising demand and the complex health needs of the ageing population will further add to the pressure.

"At the same time, the rising workload is placing greater pressure on staff who are working hard just to maintain services at their current levels.

"It is vital that change is informed by those who work in the service and those who can see where the real pressure points are.''

The Liberal Democrats said the concerns were a reflection of "eight years of inaction'' by the SNP Government.

The party's health spokesman Jim Hume said: "People will wonder why successive SNP health ministers have failed to get a grip of the pressures which we've known were on the horizon for many years. They have had the full power of government to support our hospitals.

"The facts are that the crisis in our A&E units continues, hospital beds continue to be cut and NHS staff do not have the resources they need to meet demand.''

Ms Robison pointed to record staffing and funding, and the Government's plans to integrate health and social care to shift the balance from hospitals to the community.

She said: "While we must consider the future of our health service, we should not lose sight of how far we've come.

"Substantial improvements under this Government have led to historically-low waiting times, large reductions in MRSA and C diff rates in our hospitals, and delivery of some of the most high-quality and safe healthcare anywhere in the world.

"But we fundamentally agree with the proposition that we need to change and evolve our health and social care services to meet rising demand, tackle health inequalities and meet the challenges of an ageing population.

"I set out our willingness to engage in this long-term debate in Parliament earlier this year and I'm encouraged to see professional bodies making a positive contribution.''

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