More holes than cheese. What prevents the delivery of effective, high quality, and safe healthcare in England?

What prevents the delivery of effective, high quality, and safe healthcare in the National Health Service (NHS) in England? This paper presents 760 challenges which 330 NHS staff reported as preventing the delivery of effective, high quality and safe care. Some problems have been known for over 25 y...

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Bibliographic Details
Main Authors: Sue Hignett, Alexandra Lang, Laura Pickup, Christine Ives, Michael Fray, Celine McKeown, Sarah Tapley, Matthew Woodward, Paul Bowie
Format: Article
Language:English
Subjects:
Design not elsewhere classified
Design Practice and Management not elsewhere classified
Education
Ergonomics
Healthcare
Human factors
Human factors integration
Patient safety
Systems
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Summary:What prevents the delivery of effective, high quality, and safe healthcare in the National Health Service (NHS) in England? This paper presents 760 challenges which 330 NHS staff reported as preventing the delivery of effective, high quality and safe care. Some problems have been known for over 25 years (staff shortages, finance and patient complexity) but other challenges raise questions about the commitment of the NHS to patient and staff safety. For example Organisational Culture leading to ‘stifling bureaucracy’, ‘odds stacked against smooth […] working’ and Workload resulting in ‘firefighting daily’ and ‘perpetual crisis mode’. The role of Human Factors/Ergonomics professional input (engagement with safety scientists) is discussed in the context of success stories and examples of Human Factors Integration from other safety critical industries (Defence, Nuclear and Rail).