GPs look for lessons as Mid Staffs goes into administration

GPs in Northern Ireland have condemned the 'target-driven' NHS system and will investigate whether the Mid-Staffs scandal has lessons for them.

Dr Brian Patterson: do we have a Mid Staffs in Northern Ireland?
Dr Brian Patterson: do we have a Mid Staffs in Northern Ireland?

Mid Staffordshire NHS Foundation Trust yesterday became the first foundation trust to go into administration.

The annual conference of LMCs in Northern Ireland on 14 April voted to ask GPC leaders to study the Francis report into the failures of care that led to hundreds of avoidable deaths at Mid Staffs.

Robert Francis QC published the findings of his second report last month, examining how the NHS in England failed to detect and address the trust's inadequacies earlier.

Dr Brian Patterson of Northern LMC said he had been amazed that the Francis report had not been ‘on the radar’ in Northern Ireland, and urged GPC Northern Ireland to spend some time looking at the issues raised.

Dr Patterson asked: ‘Do we have a Mid Staffordshire in Northern Ireland? Do we know? What should we base that opinion on? Are the statistics in Northern Ireland reliable?’

He said for individual GPs there had been a huge number of questions raised by Francis that GPs needed guidance on such as the duty of candour, the role of whistleblowers, bullying, the role of responsible officers, training issues, teamwork issues, multidisciplinary roles, and targets.

Dr Tom Black, chair of GPC Northern Ireland, said the Francis report had been the ‘most significant report in the  health service in a decade or more’ and there were many lessons and a great deal of guidance relevant to general practice.

A second motion demanded a return to ‘holistic patient centred care’ and condemned Northern Ireland's Department of Health, Social Security and Public Safety (DHSSPS) and the Health and Social Care Board for the ‘target-driven, box-ticking’ system discredited by Francis.

Dr Louise Rusk of Eastern LMC said general practice consultations were complex and could not be predicted or described using simple linear measures.

She asked the DHSSPS and the health board to recognise it was ‘not possible to measure everything’. ‘We need time to deal with the unmeasurables,' she added.

Dr Rusk said patients arriving with a list brought despair because doctors also have a list to get through, and the balance was tipped in a way that could adversely affect patients.

Francis wrote that patients ‘need to come before numbers’, Dr Rusk said, ‘and we need to learn from that’.

She added that while GPs were pleased with the result of the GMS deal which cut the number of indicator thresholds from the imposed contract, the agreement was not ideal and GPs needed to ‘send a very strong message about the direction of travel’.

A DHSSPS spokesperson said: 'The focus, as reflected in the changes secured under the General Medical Services Contract for Northern Ireland, is to promote improvements in the quality of care for patients and to ensure that more patients will benefit from care that enhances quality of life.'

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