More than half of NHS staff working for strategic health authorities and primary care trusts believe the government's shakeup of the health service could hit patient care and few of them believe the reorganisation will be worth it, according to a new poll.
A third of the 400 respondents to the online poll from E-Health Insider's website said they expected no benefits at all from the coalition government's NHS white paper. More than half thought it would lead to poorer patient care. And just over a quarter feared that "the reorganisation could distract attention from quality/patient safety".
NHS chief executive Sir David Nicholson has admitted that staff may find the changes hard to handle and that "large numbers of people may lose their jobs". The survey bears this out:
- 58% of respondents said that morale has declined "greatly" and 28% said it has declined "slightly" at their organisation.
- 38% of respondents said they expected to lose their job as a result of the changes, and only 16% were confident of keeping it, while 65% thought job losses would result in a "big" or "some" loss of skills.
When he launched the white paper, the health secretary Andrew Lansley said it would leave professionals free to "focus on improving health outcomes so these are among the best in the world". The survey shows considerable scepticism about these claims:
- Just 15% thought patient care would improve greatly or by a small amount, while 33% thought the white paper would have no impact on patient care, 28% thought it would deteriorate and 25% thought it would deteriorate greatly.
- 33% said there were no potential benefits to the white paper, and while 21% thought it would "cut needless bureaucracy" only 7% thought it would "give power to the right people - GPs" and only 4% thought it would "end political interference in the NHS".
- (10% thought the white paper’s proposals for hospitals and other providers would improve quality, 6% thought more choice would empower patients, 5% thought the public health service would tackle health inequalities, and 15% suggested other benefits).
Meanwhile, there was concern that the white paper contained a number of threats for the NHS.
- 26% felt the reorganisation could distract attention from patient quality/safety, and 19% thought it could trigger a financial crisis. 21% thought the commissioning changes could lead to a loss of accountability and 12% thought they would present an opportunity for the private sector.
- (8% thought the provider changes would let in the private sector, 5% thought choice would widen health inequalities, 1% thought there were no threats and 9% suggested other threats).
Jon Hoeksma, editor of eHealth Insider, said: "What is surprising is just how little confidence there is that the changes will be worth it, and how few people think the white paper will improve patient care. If there is a big idea behind these changes, the government needs to spell it out and start working to take people with it."
- The online survey on the NHS white paper was conducted over a month from 20 August to 17 September. The results are published ahead of the Conservative Party conference and a week before consultation on the white paper closes.
- The poll was completed by 403 NHS staff working for SHAs, PCTs and health informatics services, in jobs covering IT (65%), general management (11%) and commissioning (16%).
- Three quarters of those completing the survey had worked for the NHS for more than five years, including a fifth who had worked for the health service for more than 20 years. Almost half were department heads or senior managers.
- The white paper will lead to the abolition of SHAs and PCTs. Their planning and purchasing functions will pass to an "autonomous" NHS Commissioning Board and new GP consortia, while their public health functions will pass to a new public health service and local authorities.
About E-Health Insider
E-Health Insider is the independent online news and information service dedicated to healthcare information technology issues. This portal attracts a readership of IT industry and healthcare professionals worldwide.
http://www.e-health-insider.com
About NHS White Paper
The NHS White Paper, Equity and excellence: Liberating the NHS, sets out the Government's long-term vision for the future of the NHS. The vision builds on the core values and principles of the NHS - a comprehensive service, available to all, free at the point of use, based on need, not ability to pay.
Download White Paper: Equity and excellence - Liberating the NHS (.pdf, 339 KB)