It is ludicrous to fine hospitals millions of pounds as they struggle to cope with demands placed on them.
The A&E and care quotas, which last year saw King’s College Hospital NHS Foundation Trust fined over £2million, only helps to push it further into debt. The more the hospital is in financial trouble the more patients lose out. While here the GP bodies – the Clinical Commissioning Groups (CCGs) – who collect the money from the fines, have been reinvesting them back into the hospitals, it still seems a roundabout way to operate.
Thankfully these government targets imposed by NHS England are being suspended next year. But they should be done away with altogether.
A&Es have become much busier over the last ten years – mostly due to people getting bigger, older or just frustrated by the changes to GPs out-of-hours services. It has resulted in our ambulances stacking up, patients stuck on trolleys and people waiting longer to be seen. It is therefore extremely short-sighted for the hospitals to then be fined £120 per patient for everyone over the five percent tariff waiting four hours or longer. With that money going out of the hospital what hope do they have of making improvements?
The Labour government’s solution to the continuing demands on A&E was to give hospital targets. David Cameron came to power claiming these targets were making the matter worse and vowed to scrap them. But he has kept some the targets and even introduced new ones.
This system must surely just create yet another layer of administration at a time when chief executives of NHS trusts like King’s and Guys’ & St Thomas’ should be helped to hire staff, set up specialist teams and take other steps to tackle the underlying problems that have led them to breach targets in the first place.
In last week’s Southwark News we reported how the Evelina Children hospital was awarded “outstanding” in its first ever inspection by the Care Quality Commission and how the trust was rated “good” despite operating in “challenging times.” In fact Guys’ & St Thomas’ A&E Department was rated “outstanding” in this report, yet the hospitals were fined £383,204 by Lambeth CCG and £329,061 by Southwark CCG.
Targets and fines have a place, but to impose them in such a blinkered and intolerant way across large organisations like hospitals that are struggling with the demands of the modern world is simply counter-productive.