Shortages of staff and equipment weigh on doctors’ decisions, survey reveals

Two-fifths of NHS staff say a ‘blame culture’ prevents people admitting to mistakes in care

NHS workers have revealed staff shortages affect their treatment decisions (PA)

Staff shortages and a lack of equipment are affecting the day-to-day decisions about patient care by doctors and nurses, a new YouGov survey has revealed.

The representative survey of NHS clinicians revealed more than half, 54 per cent, admitted that factors such as a lack of staff played a role in their decisions about patients beyond what was in their best interests.

Almost a third of staff, 31 per cent, said staffing levels were the top factor affecting decisions about patients. A fifth said the availability of services such as key tests were a significant factor; 16 per cent cited a lack of equipment; and 12 per cent cited beds.

Ten per cent of clinicians said a fear of being sued was part of their decision-making.

YouGov carried out the research for JMW Solicitors and weighted the responses to be representative of the NHS workforce population.

It also revealed more than two-fifths of clinicians, 42 per cent, believe a “blame culture” in the NHS plays a top role in preventing staff admitting to mistakes in care.

In maternity services specifically, 68 per cent of nurses and midwives said at least one factor other than what was in patients’ best interest played a role in their decisions.

Staffing levels were cited again as having the biggest impact with 46 per cent citing this as an issue.

The Royal College of Midwives has said the NHS is short of 3,000 midwives while the Royal College of Obstetricians and Gynaecologists said consultant levels could have to increase by 20 per cent to make wards safer.

Across the NHS there were just under 40,000 vacancies for nurses before the coronavirus pandemic, with 100,000 vacancies overall in the NHS.

Nicola Wainwright, clinical negligence partner at JMW Solicitors, said: “Most patients would expect their best interests to be paramount when decisions are being made about their care and it is extremely worrying that it is not always the case. The factors that impact on decision-making, such as staffing levels, need to be addressed to improve patient care and safety.”

She said ministers also needed to correct the blame culture that was stopping the NHS from learning from its mistakes.

“Blame culture has been identified by governments and health secretaries over many years as a problem when it comes to learning from mistakes, but there is still no resolution in sight.

“It seems to be accepted that a ‘blame culture’ exists in the NHS, but it has not yet been dealt with, even though it, rather than families fighting for justice, is what would seem to prevent a more open approach where the NHS accepts mistakes can and will happen. For patient safety to improve a transparent approach is needed where medical staff can discuss and learn from mistakes.”

The government has committed to increasing the numbers of registered nurses in the NHS by 50,000 by 2024.

The latest figures show a 26 per cent jump this year in the number of students applying to train as nurses with 29,740 acceptances in England, 6,110 more than last year.

Latest statistics show there are 14,800 more nurses working in the NHS compared to last year but the health service is struggling to keep up with patient demand.

NHS England has set out plans to invest £180m to boost nurse training and recruitment including more employment of overseas nurses.  

YouGov surveyed more than 1,000 healthcare professionals between 13 and 19 October online.