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‘Incentivised ignorance in NHS Trusts’

The culture of the NHS, and the incentives offered to staff all act to make sure that NHS managers act against their better judgement, Roger Taylor has told The Telegraph.

Taylor, the founder of Dr Foster, a provider of comparative information on health and social care services, said incidents like the Mid Staffs scandal would be witnessed again if no change is made to the rewards and the punishments that shape the behaviour of NHS organisations.

“What happens when a hospital like Mid-Staffordshire finds it is struggling to deliver a high quality service with the resources available? As an NHS chief executive in that situation, you could simply overspend and breach your targets – and quite likely lose your job. You could try to argue to re-organise services but you are likely to face considerable opposition from both clinicians and the public. Or you can just cut costs, cross your fingers and and hope that no-one notices if the standards of care deteriorate,” he said.

In cases the like the Mid Staffs scandal, evidence shows that the reason they take place is not that organisations fail to take any action. They conducted many investigations and did not acting on the data but simply asked more and more questions.

“Actually, this is the right answer. Complex data such as outcome measures require careful interpretation. They should act as spur to ask more questions. But this will only work if the people asking them are competent to judge when they are getting the right answers and have a desire to know the truth,” he told The Telegraph.

He cautioned that if the NHS is to prevent another Mid-Staffs, “front line staff must work in organisation that can recognise and reward quality care”. He advised that managers and boards must be held to account by commissioners and regulators, who areskilled in pinpointing failing services and acknowledging those that excel.