Mid Staffordshire should lead to a fundamental rethink of government policyBMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2190 (Published 08 April 2013) Cite this as: BMJ 2013;346:f2190
All rapid responses
Pollock and Rice are right to question the capacity of the QIPP programme to deliver the productivity savings required by the NHS(1). During my 12 years at NICE we spent considerable time looking at how to improve health service efficiency by reducing the use of low value interventions as well as increasing the use of cost-effective interventions. We sought to work creatively with the QIPP agenda(2). These endeavors have led me to believe that the level of savings required by the health service can only be achieved by addressing the biggest single component of NHS expenditure - people (3). However an “evidence based approach" to staffing was never encouraged, it was for local communities to determine. I fear that NHS quality may suffer as the necessary fiscal tightening over the next 5 years leads to severe restraints on staffing levels. Historically manpower planning was a sub-speciality of public health and while it was far from an exact science it was not left to the market place to decide. It is time that the appropriate level and mix of health care staff to deliver a high quality service is underpinned by research evidence in line with other aspects of modern health care.
1.Mid Staffordshire should lead to a fundamental rethink of government policy. Pollock A, Price D BMJ 2013;346:f2190 (Published 08 April 2013) 10.1136/bmj.f2190 23568839 bmj.f2190
2.Reducing ineffective practice: challenges in identifying low-value health care using Cochrane systematic reviews. Garner S, Docherty M, Somner J, Sharma T, Choudhury M, Clarke M, Littlejohns P. Journal of Health Services Research & Policy Vol 18 No 1, 2013: 6–12
3.Disinvestment from low value services: nicely done? Garner S, Littlejohns P. BMJ 2011:343:d4519 doi:10.1136/bmj.d4519 http://www.bmj.com/content/343/bmj.d4519
Competing interests: From 1999 to 2012 PL was the Clinical and Public Health Director of NICE