Tighter NHS Budgets 'May Hit Training'

Warning Over Emergency Care Skills Shortages


NHS hospital staff may increasingly lack the skills to provide essential care for patients in the aftermath of operations, a health expert has claimed.

Chair of the National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) Bertie Leigh has claimed tight budgets may lead to vital training becoming one of the "casualties", as senior managers try to make savings.

The comments come as NCEPOD published a report into the level of aftercare provided for patients who have undergone tracheostomies, which found many hospitals do not have the right procedures in place. At least 12,000 tracheostomies are carried out in hospitals in England, Wales, Northern Ireland and the Channel Islands each year, but the study found not all hospitals recorded how many they undertook.

Lead author and NCEPOD clinical co-ordinator in anaesthesia, Dr Kathy Wilkinson, said the report had showed failings in care including the tubes becoming blocked or dislodged. A quarter of hospitals did not provide staff with training on how to deal with these situations when they arise.

Commenting on the findings, Mr Leigh remarked: "The only way in which hospitals can maintain safe teams is to recognise training as a continuous process.

"However, with NHS funds under explicit pressure as never before, one of the first casualties is often training."

He added that the findings showing shortcomings in both the provision and organisation of clinical care meant there was a training issue to be addressed.

Speaking to the BBC about the report, Dr Wilkinson noted that a blocked tube can be a "life-threatening emergency" for a tracheostomy patient.

"The skills to sort this out need to be available or the patient can get into a lot of trouble quite quickly," she noted.

Tracheostomies are carried out by the NHS in two circumstances. One is as a planned procedure to clear a passage as required by some patients in intensive care, or those suffering some long-term conditions like multiple sclerosis. The other is in an emergency situation following an accident to aid breathing.

Expert Opinion
Patient safety must always be the priority for the NHS and ensuring that quality training is provided is a central aspect of it.

"Sadly, we have a number of cases in which patients have suffered as a result of failings in care which could be linked back to staff members not gaining access to the training they require. The only way staff can provide the necessary support is if they have the skills to do so.

"We hope that these concerns are seriously considered over the coming months and everything possible is done to ensure patients do not face risks."
Mandy Luckman, Partner