A review of bureaucracy in the NHS by the NHS Confederation has assessed the progress made in reducing the bureaucratic burden on organisations in the past three years, and looks at where new burdens may lie as a result of changes to the NHS architecture.
The review findings have led to a call to the Department of Health and Arms Length Bodies (ALBs) to help organisations focus on securing the best patient care by reducing the unnecessary bureaucratic burdens on NHS organisations. In recent years, the number of administrative staff working in the NHS has dropped by 10% and the number of managers has dropped by 18%. However, the NHS Confederation paper, Information Overload: Tackling Bureaucracy in the NHS suggests that the requests for organisations to provide information may have not decreased in line with this. The NHS Confederation has warned that, unless the bureaucratic burden on NHS organisations is reduced, there is a risk that frontline staff will be diverted from patient care to form filling and box ticking, an issue that has also been highlighted in the latest Francis report on Mid Staffordshire NHS Foundation Trust. The NHS Confederation report claims that insufficient progress has been made in reducing bureaucracy in the health service since it carried out its last review in 2009. This lack of progress may, in part, be due to a lack of cooperation between the various agencies that require information from NHS organisations, particularly agencies working at a local level. The problem is compounded by the fact that providers still lack the right to formally challenge agencies which ask for the same or similar information that has been requested by others. There is a risk that the complex structure of the new NHS and the increased number of organisations will further add to the administrative burden on NHS organisations. The NHS Confederation believes that the information demanded of NHS organisations should be limited to what is necessary to support the delivery of high-quality patient care and to drive improvements in services. It must also provide real assurance for the public on compassionate patient care. The development of a potential new inspection regime currently being considered by the Secretary of State must take account of these objectives. If this generates new information collections for the NHS, they should only be introduced if they add real value and should be compensated for by addressing burdens elsewhere. The NHS Confederation is calling on the Department of Health to support the implementation the recommendations of its review as soon as possible, to free up staff resources and money for frontline services. The NHS is committed to working with the Department and ALBs to go further and to give immediate consideration of how new burdens could be averted in the new NHS landscape. Commenting on the review findings, Mike Farrar, chief executive of the NHS Confederation, said: “NHS organisations have a responsibility to provide the right information so they are accountable to patients and taxpayers. But we need to strike the right balance of providing information which allows patients to have a clear picture of the standards of care, without spending a disproportionate amount of time providing the same information to numerous organisations in different ways. “We are concerned that patient care could be affected because organisations and staff are distracted by the burdens of administrative requests from external organisations. Our members have told us that this is a growing problem. We will be working with them in the coming months to help them address this issue and feed back their concerns and proposals to the Government and other relevant bodies.”
