NHS Figures Highlight Missed Treatment Targets

Author:
Geoffrey Simpson-Scott
Partner, Medical Negligence Solicitor
Date:
16/08/2016

NHS treatment figures for June 2016 show that several key targets are being missed, including response times for ambulances and waiting times at A&E departments.

Geoffrey Simpson-Scott, a Partner in Medical Negligence at Simpson Millar Solicitors, evaluates the figures and discusses whether patients should be concerned about these missed targets.

NHS Missing Key Targets

NHS England's monthly performance statistics for June 2016 highlight that:

  • 5% of patients wait more than 18 weeks for planned surgery

  • 30% of ambulances take longer than 8 minutes to reach the emergency scene

  • 5% of patients in A&E wait more than 4 hours to be seen

  • There has been a 23% rise in the number of patients experiencing delays in being discharged from hospital.
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Minimising Avoidable Injuries

The NHS sets these targets in order to minimise the scope for patients suffering avoidable injuries. Accordingly, any delays in providing emergency care, planned operations, or in freeing up much-needed bed space increases the risk of patients suffering from avoidable injuries.

Modern clinical governance is aimed directly at analysing the entire system in place, in order to identify any weak points. Any weak points that are identified are bolstered by a system of treatment protocols, service standards, and clinical guidelines in order to minimise the risk of individual errors causing catastrophic consequences.

This is the same system that is in place in the space and aeronautics industries and in elite sports such as Formula 1. Despite this, these latest figures indicate an ongoing failure of a system designed to protect patients.

A Game of Russian Roulette

The missed A&E target alone means that over 185,000 patients were not seen in time. While not all of these incidents would have resulted in further injuries, it should be noted that with every missed target there is an increased chance of a patient developing further injuries.

In instances where delayed treatment causes further injury, patients should make a complaint to the NHS directly, who – under the Duty of Candour – are required to carry out a full and frank investigation into the incident, with patients receiving a detailed report of their findings. Where a report highlights that further injury was caused by an NHS failing, a sincere apology should be made.

With each missed target, the NHS increases the likelihood of a detailed investigation, which will only cause a hospital's budget to be stretched further.

Discussing the dangers of these missed targets, Geoffrey said:

"Many injuries leave patients with symptoms that affect their general health, with their ability to work or to deal with the demands of everyday life seriously inhibited. These patients are likely to need compensation to help them to live with their injuries as best they can. As such, missing NHS targets is likely to lead to an increase in Medical Negligence cases."

"A common misconception is that compensation payments (and legal costs) reduce the amount of money available to treat patients. In reality, the two budgets are completely separate from each other and so winning your case does not deprive others of much-needed treatment."

"Missing these targets is like playing a game of Russian roulette and is a worrying indication that the system itself is under strain. The main concern is patient welfare and it is disturbing that other safety procedures within the treatment process are not being followed."

"I recently obtained a five-figure settlement for a gentleman who fractured the scaphoid bone in his wrist at work, which is a very common injury. Had he been properly examined at A&E, he would have made a full recovery within 3 months. However, the A&E nurse was under pressure and failed to conduct a complete examination of his wrist or to advise my client that he should return to hospital within 10 days if his pain had not cleared up. She also did not make a clear written note of her examination in my client’s records."

"By the time the fracture was diagnosed many months later, my client had suffered a permanent injury as a result of the bone healing poorly. My detailed examination of his case showed that if the A&E nurse had properly examined my client, there was less than a 1% chance of the fracture being missed. A simple standard examination form in use at similar hospitals was not available and this hospital had been missing its four-hour A&E targets for a prolonged period of time when my client attended."

Getting Legal Advice

Missing targets increases the risk of patients suffering significant avoidable injuries. NHS targets are in place to minimise this risk and so it is hoped that genuine and sustained measures are put in place to prevent this happening in future.

Unfortunately, litigation is often the only tool available to patients suffering from the consequences of missed targets. Many of our Medical Negligence clients want to know that what has happened to them will never happen to anyone else but, sadly, we see the same mistakes being repeated time and again. These latest missed targets indicate that this will continue to be the case for the foreseeable future.

Geoffrey Simpson-Scott comments:

"Consent is key when it comes to prescribing treatment, with the autonomy and best interest of the patient, young or old, being at the heart of everything the medical profession now does. When this is called into question, it is for the court to determine whether sufficient information was provided, allowing the patient to make an informed decision, as opposed to undertaking what is simply standard medical practice in their situation."

"Where there has been no reasonable attempt to obtain a patient's consent, the doctor or medical authority in question can find themselves ruled to have caused a deliberate injury (a battery). It is also often necessary, however, to prove that an injury was caused by the drug or treatment in question."

"In cases where there is a dispute between the parents of a child or an adolescent patient and a clinical team over treatment, the court is guided, again, by what is in the child's best interest, which, in certain cases, overrides a lack of consent from the parent or child."

"What the release of the file regarding the Richmond Hill Approved School demonstrates is how far we've come since then. Consent aside, the level of information given to the boys back then would've been far less than is required nowadays. Whether the tests resulted in any adverse effects is unknown, although the drug had been approved for use on humans, so was not itself inherently dangerous."

"Another question hanging over these trials is whether – despite Home Office approval to go ahead – they complied with the principles of the European Convention on Human Rights (ECHR), which was ratified in the UK in 1951. This could play a key role in any legal proceedings that arise following this recent disclosure."

"It is unclear whether any modern court would approve of what happened in 1967 applying the standards that were then in place, which is why it's important that incidents like these are out in the open and those affected are able to seek careful advice and legal redress, ensuring it never happens again."

This information was originally published on our website on 16/08/2016.

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