Auditor queries NHS productivity.......

azzuri · Auditor queries NHS productivity.......

see - http://news.bbc.co.uk/1/hi/scotland/4525308.stm

Auditor queries NHS productivity

A lack of information has made it unclear whether NHS productivity has been boosted by medical staff pay deals, Scotland's Auditor General said.

Robert Black said the NHS was providing improved healthcare and "significantly" reducing treatment waiting times.

However, in his NHS performance report for 2004-05, he noted some boards had not supplied information on sickness absence and the use of agency nurses.

Mr Black called for improved workforce planning and financial management.

In 2004-05, the NHS consumed about one third, or £8bn, of the Scottish Parliament's entire budget for devolved services.

Mr Black told Holyrood's all-party audit committee that NHS Scotland spending would reach £10.3bn in two years time.

With a workforce of 150,000 the health service is Scotland's biggest employer.

However, Mr Black said sickness absence in NHS Scotland was higher than many other parts of the public sector, with 5.3% of available hours lost.

He pointed out that some health boards were failing to provide a full picture on sickness absence.

'Information needed'

Basic information was also found to be lacking in some other workforce areas, such as the use of bank and agency nurses and progress against recruitment targets was mixed.

Mr Black said better information was urgently needed about the level and type of work being carried out in the NHS so that, for instance, the shift from inpatient to outpatient could be measured.

"There have been some improvements in the collection of activity data, such as nurse-led clinics," he said.

"But the NHS has still some way to go to provide a comprehensive picture of its activity, costs and quality of treatment."

He said there was insufficient information to explain the continuing decline in the number of planned hospital treatments for more than a decade and a levelling off of day cases and emergency admissions since 2002-03.

'Costs increasing'

"It's entirely reasonable to ask the question of the health service what is happening in the system when we see that trend emerging at the same time as there are extra resources going into pay deals to improve the flexibility and quality of care," he said.

However, he added: "We do not have an explanation for this. For example, we cannot say whether the trend is a result of quality improvements or a more complex mix of cases.

"Nor can we say whether there are growing problems of efficiency.

"So the question of whether productivity as a whole is improving must remain unanswered, at the same time as we know that costs are increasing as a result of new pay deals."

The additional costs of implementing new pay deals are estimated to be £291m in the current financial year 2005-06.

The BBC almost sound surprised. Confused

The NHS and productivity!?!?! No bloody wonder it's productivity level is so low. Too many administrators and management that have no 'medical' skills whatsoever. What is needed is to streamline all of the management, independent administrators, auditors et al and use the wages saved to recruit extra doctors and nurses!!!!

Doctors and nurses are overworked as it is becasue of staff shortages. These long hours lead to unhappiness and disillusionment with their jobs, which in turn leads to a lower output of work from these staff. So what do the NHS do to keep them happy? - give them 10% wage rises!!! Except that wasn't the problem in the first place - it's the fact there aren't enough medical staf to perform all the medical tasks! So a doctor who is unhappy working long hours for 50 grand a year will be just as unhappy working long hours for 55 grand a year!

Why not get 10% extra MEDICAL staff in to help the burden of overworked staff, therefore creating extra jobs, gaining increased output of the whole hospital with it. Then sack all the managers and auditors who go about creating worrying statistics and putting medical staff under pressure with 'targets'.

In the USA their hospitals have very few non-medical staff, and this is why their private hospitals turn a profit (as well as underpaid doctors, but that is private enterprise). I'm not saying we should adopt private healthcare, but the NHS needs to be more efficient. Is it any wonder it's not with the amount of money being shelled out on management, statistics, targets, middle managers etc. etc.

Reluctant Hero

It is a common perception on the outside world that the NHS is inefficient. But let me ask this question. What is the measure that the NHS is being compared against? The NHS is a unique employer, so how people can say it is inefficient is beyond me. Ofcourse there are going to be pockets of inefficency, but you would expect that in such a massive employer. How is a doctor physically capable of saving more lives than he does? It just isn't possible.

I work in the organisation that collects statistics for the Scottish NHS and this information is essential for the planning of future services in the NHS. Although the pressure put on meeting some meaningless headline targets by MP's is ludicrous.

fof

Andy Kerr will deliver results but not the ones I want.

I have unfortunately had to have dealings with the NHS since the 1980's and with out a doubt the standards have dropped from the cleanliness to the standered of care.

If I'm correct the consultants have signed new contracts that give them shorter working weeks as have the G.P.'s so how can we expect the waiting lists to get shorter. We also now have specialised clinics run by nurses and G.P.'s and as far as I can see all that has happened is you go to one of these clinics and then they write to your G.P. with suggestions that they can try with you, (these are the same things your own G.P has already tried,) then a few months down the line your referred back and they say you will need to see a consultant. So once again your on the round about. If your G.P is one of these specialists (and they want all G.P.'s to specialise in some thing) you then have longer to wait for a G.P.'s appointment at your surgery.

Then on top of that we have now been told that we will be treated in our local cottage hospital by out specialised G.P.'s and will not have to travel to the hospilals in the city as they will be come centres of excellence, now does this mean that the people in the city will be treated in special clinics in their G.P.'s surgeries or will they be treated in the city hospitals before the people from out of town.

They are trying to move a lot of our surgery from A.R.I. to the central belt, and A.R.I looks like becoming a cottage hospital instead of one of the countries leading hospitals. We always said that if we got devolution or independence that there would be nothing considered important north of Dundee and that is certainly becoming true of the N.H.S.

What about N.H.S. 24 out of hours line, it is a disaster, it was piloted up here and had so many bad points that should have been seen to before it went nation wide, but would they listen no. Ambulance Centres are just as bad, an ambulance took so long to reach a patient that he became dangerously ill, why because the centre did not know the local area and it sent an ambulance from 20 miles away instead of one 5 miles away.

No Andy Kerr's idea's will do little to improve our lot with the N.H.S.

wisnaeme

Couldn't put better than yerself,"fof". Aye, I have had a fair bit of experience with the NHS as weel. Isn't it a contradiction in hypocracy that yer New Labour "enforcer",the guid "Doctor" Reid is so vocal in his opposition to the closure of the New Monklands Hospital Aand E Dept in Airdrie, yet it is himself and others within the inner cabal of New Labour that influenced the Health Board's decision for the "preferred option?" Wee Jack and Andy Pandy dae as they're telt,regardless o their strutting around Holyrood an ither foreign pairts.Maybe the A & E Dept will be saved by the guid "Doctor" Reid's intervention and ra punters will be so grateful that they'll vote fer the New Labour donkey next time,again. Aye, playing politics wae folk's lives and fears is a dirty game,right enough.

wisnaeme

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Aye,it doesn't look if it is going to get any better,either.

http://news.bbc.co.uk/1/hi/health/4862318.stm

. Sad

fof

Thanks for the link wisnaeme made for good reading

I saw the ITV dinner time news the other day and they kept banging on about England and how much the hospitals had over spent, they did a survey in England and no where else as if none of the rest of the country exists. On the tea time news they never mentioned the survey was only done in England so I guess they had complaints.

When you listen to the news it is always the NHS in England and Wales that is talked about never Scotland, then our minsters in Edinburgh slip in our new rules by the back door and it's to late to complain.

We had special meetings up here about aspects that were to change in the Grampian health area, at the first meeting they got a barrage of questions they did not want to answer, so at the second meeting we were sat round tables with two people from the NHS and we could put our questions to them, but of course we did not get much answers just told we'd get a follow up letter to tell us how the meeting had gone, the questioner was worded to give them the answers they wanted, they were not pleased when the people wrote on the questioners that they thought they were not fair in the choice of answers you could tick, they did acknowledge this in the follow up letter but nothing was changed so the answers stood. What a con they must think we are completely stupid
Maybe their right as we never seem to stick together and challenge them , a few lone voices shouting in the desert are never heard.