Keeping Patients Safe First and Foremost
It is now an inescapable fact that we are entering a period of diminishing resources. In the context of delivering patient care to the highest quality and safety standards, this represents serious challenges for health service managers. The stark reality may be that the systems over which health service managers preside, and are accountable for, may no longer be fit for purpose and ever more so in the new resource environment.
The increased regulatory environment in healthcare and the drive towards standard delivered care are, of course, hugely welcome. We are, however, too well aware over recent years of the consequences for patients, managers and clinicians where the appropriate standards are not being met, and we are aware of the system and individual shortcomings which would have contributed to these. Critical to the delivery of a safe and quality service is that our hospital and community delivery systems and structures are fit for purpose. With diminishing resources, managerial, clinical and other, it is no longer satisfactory to ask that managers and clinicians preside over systems that do not present as strategic, coherent and integrated solutions for local (and regional) health care delivery. Our current systems in many areas are bedevilled by local politics (medical and other) which has led to a diffusion of services, lack of co-ordination of thinly spread resources, stilted regional development and a failure and inability to concentrate resources in the manner which research evidence indicates is best for patients. The one notable exception, of course, is cancer services, where local medical and political opposition was faced down and where we have rationalised cancer services into eight designated centres, presided over by managers who have full knowledge and understanding of the tasks given to them and the resources available to achieve same.
We need similar determination to deconstruct systems which, in some areas, are past their sell by date, are wasteful of resources and do not serve the best interests of patients. It is clearly in the interest of managers and is about maximising quality and patient safety, first and foremost.
Richard Dooley, President, HMI