Opinion – Managing the costs of clinical negligence in NHS trusts – National Audit Office (NAO)

Citing review of ten years data, the NAO reports that the cost of clinical negligence in NHS trusts is significant and rising fast, placing increasing financial pressure on an already stretched system.

Source: Managing the costs of clinical negligence in trusts – National Audit Office (NAO)

The key findings are:

  1. The cost of clinical negligence claims is rising at a faster rate year-on-year, than NHS funding
  2. Even if successful, NHS Resolution and the Department’s current actions are unlikely to stop the growth in the cost of clinical negligence claims
  3. The government lacks a coherent cross-government strategy, underpinned by policy, to support measures to tackle the escalation
  4. The increase in damages is driven by a small number of high-value claims, while the increase in legal costs is mainly due to a large number of low- and medium-value claims up to £250,000

For me there are probably three fundamentals which this report is too polite to identify.

Firstly, politicians have consistently meddled and provided knee jerk reactions, failing to look at the NHS crisis holistically from a strategic perspective. Rather than radically reform the public health industry, the government is too weak and introducing piecemeal outsourcing which is clearly sub-optimal.

Secondly, the NHS is ineffectively managed, relying upon a narrow group of industry specialists, rather than opening its ranks to world class talent from other sectors.

Thirdly, the various political stakeholders in the UK’s public health industry are typically putting their own interests ahead of patients. In the private sector, there’s a wealth of research confirming the market oriented businesses consistently achieve superior fanancial performance. Within the NHS, there’s a ‘one-size-fits-all’ policy to patients, treating them more as children than customers.


BMA – Outsourcing firm and US healthcare insurer team up to run STP – BMA

Here’s a heads-up on the next omni-shambles in UK public healthcare. The BMA is right in this hard-hitting article. It describes how an outsourcing firm – whose work for GPs was described by a minister as ‘entirely unacceptable’ – and the UK arm of a private US healthcare insurer are to lead the development of an STP (sustainability and transformation partnership). The new best practice paradigm is described as ‘shared health and care system.’

Source: BMA – Outsourcing firm and US healthcare insurer team up to run STP

The article questions how with Capita’s appalling record, it continues to win healthcare contracts. Those of us familiar with public administration, both in central and local government, will know that Capita have cleaned up with contracts across the public, despite seriously questionable results.

The Conservative Party leadership have demonstrated, time and time again, that they don’t have the stomach to lead radical change in the public sector. There’s been absence of vision and strategy, relying naively on austerity. The consequence has been back door outsourcing to the likes of Capita (and their US partners).

I have been involved in delivery transformation most of my life and must agree with the thrust of the BMA arguments.

So what’s the answer, more status quo, more outsourcing or a radical third way?