LEADING health professionals are calling for minimum staffing levels to be set for hospitals as a matter of urgency to ensure NHS patients are given the same care round the clock.
In a controversial paper, the senior medics compared the health service to the aviation industry, saying: "We would not expect passengers to accept a higher risk of their flight crashing in the evenings or at weekends due to reduced staffing or inexperience, so why should patients accept this for their NHS?"
Professor Derek Bell, president of the Royal College of Physicians of Edinburgh (RCPE), and Anne Jarvie, former Chief Nursing Officer for Scotland, said that major cultural change was needed within the NHS to improve the service.
They noted there has been "a trail" of inquiries into care failings across the UK, including reports on the Vale of Leven Hospital in Dunbartonshire, Aberdeen Royal Infirmary and Monklands and Hairmyres hospitals in Lanarkshire.
"Patients, NHS staff and the wider public may be forgiven for asking 'where next?', particularly as six of these inquiries have reported within the last two years," they wrote.
"To both the casual observer and many working within the NHS, we have witnessed a trail of inquiries and reviews that have produced hundreds of detailed recommendations, which at face value appear to have had limited effect."
Professor Bell and Ms Jarvie said poor leadership, insufficient staffing, poor communication and poor professional engagement were the key themes to have emerged from the reviews.
While policymakers have increased the regulation and inspection of NHS services, they said this would not prevent another hospital scandal on its own.
The article, published in the journal of the Royal College of Physicians of Edinburgh, added: "We need to develop minimum staffing levels for doctors in the medical specialties and other professions in hospitals and this is urgently required for medical staff for out of hours including weekends and hospital at night rotas.
"There is strong evidence to show the increased risk of death and poorer outcomes in patients when treated out of hours when staff capacity is reduced, and a solid case for developing seven-day working.
"Returning to the experience of the aviation industry, we would not expect passengers to accept a higher risk of their flight crashing in the evenings or at weekends due to reduced staffing or inexperience, so why should patients accept this from their NHS?"
Their comments have been widely endorsed, with support expressed by Lord MacLean, chair of the inquiry into the fatal clostridium difficile outbreak at the Vale of Leven, as well as the Scotland Patients Association and the Royal College of Physicians and Surgeons of Glasgow.
The editorial contains six recommendations, including all political parties to commit to minimum staffing levels and reminding NHS staff of both their value and responsibilities.
Ms Jarvie, who is now chair of the RCPE Lay Advisory Group, said: "NHS staff are highly committed individuals who want to do the best that they can for their patients at all times. However, the experience gained from recent inquiries into serious failings in care would suggest where failings have occurred, staff had not been engaged and something had happened to reduce their levels of compassion.
"Conversely, there is published evidence to show that where NHS staff are engaged, a range of outcomes for patients were improved."
A Scottish Government spokeswoman said the administration had "led the UK in putting in place planning tools for the nursing workforce which set a recommended level of staffing, depending on the workload of individuals wards and departments".
"This nursing workload and workforce planning tools, which have been mandatory for all boards since April 2013, provide evidence based recommended staffing levels which are tailored to individual wards," she added.
However, she agreed with Professor Bell that lessons must be learned when standards have slipped.
The spokeswoman added: "That's why we are taking forward all of the recommendations from the Vale of Leven report in partnership with health boards.
"We are also in the process of engaging with partners and the public on mapping the long term future of our NHS, which will consider resources like staffing, and how we manage care between acute hospital settings and the community."
xref leader and agenda
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