‘Nothing has changed since Mid Staffs probe’, senior medic warns

“Nothing has changed” since the public inquiry into care failings at Mid Staffordshire NHS Foundation Trust, a leading medic has warned.

Dr Chaand Nagpaul, chair of council at the British Medical Association (BMA), called for a cultural change in the NHS as he warned that medics do not feel confident to speak out about patient safety concerns.

The majority of doctors are worried that they will make errors in care due to issues outside of their control – like low staffing levels or a lack of resources, he added.

Addressing the union’s annual representative meeting in Brighton, Dr Nagpaul said: “We need radical cultural change in our NHS.

“Nine in 10 doctors fear making medical errors daily due to lack of resources or workforce capacity, half of doctors don’t feel confident to speak out about patient safety concerns, fearing they’ll instead be blamed for systemic failings, creating a vicious cycle whereby a lack of openness prevents learning and continues to perpetuate avoidable harm.

“These are the hallmarks that led to the tragedy in Mid Staffs.

“Where international patient safety expert Don Berwick pointed not to NHS staff as being culpable, but that the problem lay with systemic constraints, targets, and a toxic culture of fear and blame.

“Ten years on it’s shameful that nothing has changed, with the very same headlines of staff terrified to speak out in Shrewsbury echoing through the Ockenden report.

“This demands an end to doctors working in a system that sets them up to fail, with too few doctors trying to do the impossible of being in two places at once.”

Hundreds of patients died at Mid Staffordshire NHS Foundation Trust due to poor care between 2005 and 2009.

The public inquiry into the scandal, which was published in 2013, highlighted “appalling” treatment of patients and made sweeping recommendations for change.

Meanwhile Dr Nagpaul also called for reform of the way doctors are regulated, saying that regulators should consider the circumstances under which a doctor is working.

“The system designed to protect patients but is itself undermining patient safety by hunting down and putting individual doctors in the dock, while often leaving wider systemic failings completely off the hook, without accountability nor improvement,” he said.

During his final speech as chair of council before retiring from the role, Dr Nagpaul criticised high levels of doctor vacancies, cuts to health service spending, and the reduction of hospital beds in the NHS.

He described how doctors are “utterly exhausted, their wellbeing rock-bottom and half reporting their mental health has been affected”.

The NHS has survived “thanks to the goodwill of staff”, he said adding: ” I warn ministers that you cannot run an NHS perpetually by exploiting a well of goodwill which has totally run dry. Doctors will and are walking away.”

Dr Nagpaul also said that discrimination and inequality “run rife” in the NHS workforce.

He highlighted racial disparities as well as sex discrimination, adding: “My wife, sister, and now my daughter are all doctors. I’ve seen their reality of the additional hurdles and discrimination women face in our health service.”

Dr Nagpaul also hit out at the Government over the partygate affair, saying: “It’s an absolute insult to the dedication of doctors that as we topped up IV fluids to sick patients, they merrily topped up their glasses in defiance of the rules they themselves set.”