Date Published: 8 March 2007
Bureaucratic burden in the NHS increasing - say NHS leaders (UK)
Bureaucratic burdens on the NHS are increasing. This is the stark message of a new report by the NHS Confederation published today. Whilst the government and regulators have made commitments to reduce the regulatory burden in the NHS, The bureaucratic burden in the NHS reveals that NHS organisations are actually reporting an increase.
In the most up to date and accurate list available, the report identifies a staggering 56 bodies that have a role in inspecting, assessing or monitoring the NHS. These organisations, that can visit trusts, request information or inspect, range from the Healthcare Commission to the NHS Litigation Authority. In fact there are so many bodies that have a role in this area, the report's authors found it difficult to identify the precise number.
The bureaucratic burden in the NHS also states that the Concordat has failed to be as effective as the NHS hoped.
The Concordat is perceived as weak for two main reasons. First, it is not obligatory that all inspectors and regulators sign up to it. And second, the Concordat is mainly concerned with the coordination of visits and inspections, rather than the coordination of the evidence and information required to be collected.
Although NHS Confederation members state in the report that uncoordinated visits and inspections do contribute to the bureaucratic burden, inspections are only secondary to the main source of the burden, which is the quantity and nature of the evidence and data demanded by inspectorates and other external bodies. For example, the Clinical Negligence Scheme for Trusts (CNST) and the Annual Health Check are frequently cited as overlapping in terms of the evidence they requested from NHS organisations. This duplication is a drain on resources that cannot be justified by the marginally different format of the data and evidence requested by both inspections.
The report concludes that the government's regulatory review is an ideal opportunity to address NHS leaders concerns and create a regulatory regime that is fit for purpose for the 21st century. The report's key recommendations include:
- The Concordat should be strengthened and extended to all organisations that have a remit to inspect, assess, ask for information or monitor the NHS. It should be extended to cover the duplication of information required by regulators;
- Sharing of information between regulators should become the norm to reduce the duplication of activity on the ground in demonstrating compliance;
- The number of inspections and data collections within the NHS must be rationalised and driven down. And those inspections that are retained must be managed so that they don't lead to unnecessary evidence gathering;
- The current Standards for Better Health must be reviewed and reduced to constitute no more than a minimum set of standards that will guarantee NHS organisations and non-NHS organisations entry into the market.
Dr Gill Morgan, chief executive of the NHS Confederation which represents over 90% of NHS organisations, said:
" NHS leaders welcome meaningful regulation and inspection, but unsurprisingly they don't like excessive bureaucracy.
_ Regulation is not an end in itself. It will only fulfil its purpose if it helps NHS organisations assess themselves as a way of driving forward improvement and providing public assurance about quality and safety of the service.
_ If we are serious about NHS reform and all that it entails, then it logically follows that a radical change of the regulatory system is needed. We cannot enter the new NHS with all the baggage of the past system that in the new climate will simply not be fit for purpose."
Source: NHS Confederation (UK).