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Over-regulation is eroding trust in doctors, NHS England warns

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g7083 (Published 21 November 2014) Cite this as: BMJ 2014;349:g7083
  1. Matthew Limb, freelance journalist, London, UK

Over-regulation in the NHS may erode people’s trust in doctors and clinical teams “to do the right thing,” attendees at the King’s Fund’s annual conference have been told. Speakers at the conference said that an unforgiving industry climate driven by rules and sanctions had left many frontline NHS staff fearful of making honest mistakes in the pursuit of improving care.

Ed Smith, NHS England’s deputy chair who also chairs its audit committee, said, “I think over-regulating professionals can erode the foundation of their work, and people switch off. If trust exists solely because there are sanctions against those individuals we don’t actually trust people at all.” He added, “The more we rely on rule following to shore up trust, I would argue the less likely [it is that] trust will be based on assumed integrity.”

Smith spoke at …

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