Ambulance staff falsified response times figures to meet NHS targets
Ambulance control room staff changed response time figures, improving the trust's performance against government targets, an Audit Commission investigation has revealed. Managers and the board at the former Wiltshire Ambulance Service trust, now part of Great Western Ambulance Service trust, put pressure on the control room to meet targets 'at all costs' but failed to manage staff effectively or properly follow up concerns about the number of figures being manually altered on the computerised control system, says the report, published last week.
From 1 April 2005 to 17 July 2006, control room staff manually changed response times or dispatch codes for hundreds of calls, bringing many within the target time of eight minutes for a life-threatening case.
Staff could make changes because automatic recording of data relied on ambulance staff hitting the right button at the right time. In cases where this did not happen the details were recorded manually, allowing staff to enter incorrect data. Some services, such as motorcycle units, were not even on the automatic system.
Staff interviewed in the audit could not explain why they had altered data but the report says: 'Control room staff think there should be a stronger link to patient outcomes. They are frustrated that a category-A incident...met within the eight-minute target is considered a "success" even if the patient dies, while an incident where the ambulance arrives in eight minutes and one second is a "failure", even if the patient is resuscitated.'
The performance of individual staff should be reviewed and the new board should decide whether any disciplinary action is needed, recommends the report.
GWAS trust chief executive Tim Lynch commented: 'Appropriate controls have now been put in place to ensure the accuracy of response-time data, along with additional management support. We can now be confident that they accurately reflect performance.'
GWAS is expecting to miss its year-end target of answering three-quarters of category-A calls in eight minutes, predicting it will answer 73 per cent within the time.
From:
http://www.hsj.co.uk/healthservicejournal/pages/N1/P12/070405
Health Direct warnes that the use of random NHS targets is creating perverse results:
On 3 Aug 2006 in NHS Hospital fined for treating too many patients when an NHS hospital has been penalised for treating its patients too quickly - losing nearly £2.5 million, the cost of the care it provided outside an agreed contract. Ipswich Hospital NHS Trust, which finished the year £16.7 million in the red, had been doing so well with waiting list targets that in one department patients were waiting only a week to see a consultant.
Andrew Lansley, the shadow health secretary, said: "It is outrageous that Ipswich Hospital is being penalised for improving on the Government's target, especially when the trust is crippled by deficit. The Government is more obsessed with meeting its targets than the interests of patients.
Even worse- on 16 Jun 06 Health Direct posted: Scare over MMR vaccine safety causes cases of Mumps to soar as immunisation postcode lottery grows when the scare over the safety of the MMR vaccine is still discouraging parents from immunisation, particularly in London, raising the risk of mumps, measles and rubella. Cases of mumps soared from 4,204 in 2003 to 16,436 in 2004 and to 56,390 last year. The exodus has been also been driven by Labour's introduction of bonus payments for doctors who meet immunisation targets leading to even more health postcode lotteries.
If a GP manages to increase the proportion of children in their area who receive vaccinations from 70 per cent to 90 per cent, their payment will increase from £995 to £2,865. However, vaccination levels in poorer areas are traditionally low as a result of deprivation, ethnic diversity and high levels of mobility. Many family doctors in these areas appear to have decided to opt out of the system because they have little chance of increasing the numbers and earning the bonus.
From 1 April 2005 to 17 July 2006, control room staff manually changed response times or dispatch codes for hundreds of calls, bringing many within the target time of eight minutes for a life-threatening case.
Staff could make changes because automatic recording of data relied on ambulance staff hitting the right button at the right time. In cases where this did not happen the details were recorded manually, allowing staff to enter incorrect data. Some services, such as motorcycle units, were not even on the automatic system.
Staff interviewed in the audit could not explain why they had altered data but the report says: 'Control room staff think there should be a stronger link to patient outcomes. They are frustrated that a category-A incident...met within the eight-minute target is considered a "success" even if the patient dies, while an incident where the ambulance arrives in eight minutes and one second is a "failure", even if the patient is resuscitated.'
The performance of individual staff should be reviewed and the new board should decide whether any disciplinary action is needed, recommends the report.
GWAS trust chief executive Tim Lynch commented: 'Appropriate controls have now been put in place to ensure the accuracy of response-time data, along with additional management support. We can now be confident that they accurately reflect performance.'
GWAS is expecting to miss its year-end target of answering three-quarters of category-A calls in eight minutes, predicting it will answer 73 per cent within the time.
From:
http://www.hsj.co.uk/healthservicejournal/pages/N1/P12/070405
Health Direct warnes that the use of random NHS targets is creating perverse results:
On 3 Aug 2006 in NHS Hospital fined for treating too many patients when an NHS hospital has been penalised for treating its patients too quickly - losing nearly £2.5 million, the cost of the care it provided outside an agreed contract. Ipswich Hospital NHS Trust, which finished the year £16.7 million in the red, had been doing so well with waiting list targets that in one department patients were waiting only a week to see a consultant.
Andrew Lansley, the shadow health secretary, said: "It is outrageous that Ipswich Hospital is being penalised for improving on the Government's target, especially when the trust is crippled by deficit. The Government is more obsessed with meeting its targets than the interests of patients.
Even worse- on 16 Jun 06 Health Direct posted: Scare over MMR vaccine safety causes cases of Mumps to soar as immunisation postcode lottery grows when the scare over the safety of the MMR vaccine is still discouraging parents from immunisation, particularly in London, raising the risk of mumps, measles and rubella. Cases of mumps soared from 4,204 in 2003 to 16,436 in 2004 and to 56,390 last year. The exodus has been also been driven by Labour's introduction of bonus payments for doctors who meet immunisation targets leading to even more health postcode lotteries.
If a GP manages to increase the proportion of children in their area who receive vaccinations from 70 per cent to 90 per cent, their payment will increase from £995 to £2,865. However, vaccination levels in poorer areas are traditionally low as a result of deprivation, ethnic diversity and high levels of mobility. Many family doctors in these areas appear to have decided to opt out of the system because they have little chance of increasing the numbers and earning the bonus.
Labels: health direct, NHS fiasco, NHS targets
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