Majority of medical decisions in Wales not based on patients’ best interests, finds survey

58% of healthcare professionals in Wales say factors other than patients’ best interests influence their medical decision-making 

Availability of services, equipment and staffing levels are top drivers of medical decisions

A majority (58%) of healthcare professionals in Wales^* say factors other than patients’ best interests play a role in their day-to-day medical decision-making, according to a new survey of medical professionals from JMW Solicitors. The survey, conducted by YouGov^**, offers insight into how medical professionals are making decisions and dealing with mistakes

It follows numerous comments by the Government on the ability of the NHS to improve quality of care and how litigation affects patient care. Aside from patients’ best interests, the top factors driving medical decision-making in Wales are availability of services (e.g. testing, referrals) (31%), staffing levels (27%), and availability of equipment (14%). Fear of being sued is not significant with only 12% believing it is a main consideration in their decision-making.

Nicola Wainwright, Clinical Negligence Partner, JMW Solicitors, said: “Most patients would expect their best interests to be paramount when decisions are being made about their care and it is extremely worrying that it is not always the case. The factors that impact on decision making, such as staffing levels, need to be addressed to improve patient care and safety.

“The Government suggests that if litigation was reduced that would help improve care, but our survey shows litigation is not actually even in the top factors affecting the care that is given.

“Moreover, litigation is often the only way for patients and their families to get answers. As several recent cases, such as the case of Elizabeth Dixon have shown, sadly, hospitals are not always open and honest when things go wrong, without families taking action themselves.

 “Instead of targeting the rights of injured or bereaved people trying to get justice the Government should be focussing on funding, increasing staffing levels and ensuring access to services, beds and equipment. It should also look at correcting the blame culture that affects the ability of the healthcare sector to learn from previous mistakes.”

86% of healthcare professionals in Wales identified factors that play a role in preventing staff admitting mistakes, which could be learnt from. Half (50%) believe a ‘blame culture’ where colleagues and management blame others when things go wrong, plays a top role.

Nicola added: “Blame culture has been identified by governments and health secretaries over many years as a problem when it comes to learning from mistakes, but there is still no resolution in sight.

“It seems to be accepted that a ‘blame culture’ exists in the NHS, but it has not yet been dealt with, even though it, rather than families fighting for justice, is what would seem to prevent a more open approach where the NHS accepts mistakes can and will happen. For patient safety to improve a transparent approach is needed where medical staff can discuss and learn from mistakes.”

Footnotes

*Wales refers to the Government Office Region of Wales.

**All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1,009 healthcare professionals in the UK. The sample size in Wales was 65 healthcare professionals. Fieldwork was undertaken between 13th – 19th October 2020.  The survey was carried out online. The figures have been weighted and are representative of the NHS workforce by occupation group at the UK level. Conclusions are to be drawn with caution as the results for Wales are based on a sample size of less than 100 respondents.