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Doctors’ concerns about care often not addressed, BMA survey shows


3 June, 2009  

Hospital doctors are frequently frustrated in attempts to raise concerns about standards of care and push forward ideas, a BMA survey indicates today.

The report, Speaking up for Patients, is to be published today at the BMA’s annual Consultants Conference in London. It is based on survey responses from 565 doctors working in hospitals in England and Wales.

Three-quarters (74%) said they had had concerns about issues relating to patient safety, malpractice or bullying, over the course of their NHS careers. Within this group, 73% said their concerns had related to standards of patient care.

Seven in 10 doctors (70%) who had had a concern raised it with the relevant authority at their trust. However, many said that their experiences of reporting issues had been negative – for example, because they were unaware that anything had happened as a result (46%), they were not approached for further information (15%), or the information they provided was shared more widely than they were comfortable with (9%).

A significant proportion (15.5%) of doctors who reported concerns said that their trusts had indicated that by speaking up their employment could be negatively affected. Despite these experiences, around three-quarters (74.5%) said they would be prepared to report concerns again in future.

In the minority of cases where doctors had not raised their concerns, this was most commonly because they were not confident that it would make a difference (81%).

In his keynote speech to the conference today, the chairman of the BMA’s consultants committee, Dr Jonathan Fielden, is expected to call for a culture change in the NHS. Commenting on the survey findings, he says: “Our report shows that doctors are clearly striving to improve quality of care.  However, it is worrying that some trusts seem to be stifling professional voices. This culture of inactivity and despair is preventing issues from coming to light, and putting patient care at risk.

“No doctor, no nurse, no porter, anywhere in the NHS should be made to feel that speaking up for their patients is a bad career move. Their concerns must be taken seriously and acted upon, and ideas for improvements should always be encouraged. A cultural change across the whole NHS is urgently needed.”

Respondents were asked whether their place of work fostered an environment in which concerns could be expressed openly.  Four in 10 (41%) agreed and three in 10 (29%) disagreed, while only three in 10 (29%) agreed that their place of work had a governance system that had the full confidence of staff, with almost four in 10 (39%) disagreeing.

Over a third (34.5%) did not agree that medical leadership was promoted at their place of work. Consultants and SAS doctors in the survey were asked whether their place of work fully supported proposals by staff to improve patient safety.  Around a quarter (24%) said that it did not.

The survey results will inform new BMA guidance on whistle-blowing, due to be published in July.

Consultant Conference