NHS managers 'fiddle figures'

A&E waiting times have been fiddled

Many NHS managers have fiddled figures to make it look like they are meeting government targets, a BBC survey reveals.

Almost one in 10 managers say they have filed inaccurate reports on key issues like waiting lists and A&E waiting times.

Many of those questioned said they were under pressure from NHS executives and regional officials to pretend they were meeting targets.

All chief executives in the region contrived to make the same 100% return to the Department of Health on absence of waits in A&E

Anonymous NHS manager

The survey of 400 members of the Institute of Healthcare Management also shows that more than half are afraid to raise concerns with senior colleagues for fear of reprisal.

The government has set a wide number of targets for the NHS since coming to power in 1997.

Strict targets

These include maximum waiting times for hospital operations and outpatient appointments, waits in A&E and strict targets for people needing cancer treatment.

Ministers have allocated money to these specific areas to help the NHS to meet the targets.

But the BBC survey reveals that in many cases the money never goes where it is supposed to.

More than one in three managers said they were personally aware of examples of money not going to its intended purpose.

Some suggested that these so-called ring-fenced funds were often re-directed to pay for computers, mental health services or fund primary care services.

Good people's principles are being compromised

Anonymous NHS manager

According to the survey, many managers file inaccurate information because they disagree with targets.

One manager stated: "All chief executives in the region contrived to make the same 100% return to the Department of Health on absence of waits in A&E.

"This was done with the encouragement of the regional director because we all agreed the requirement was meaningless."

Others suggested they were bullied by senior colleagues and felt unable to raise their concerns.

"Good people's principles are being compromised because it's only a brave person who can stand up for them and not lose the ability to pay their mortgage or maintain their families," said one manager.

Stuart Marples, chief executive of the Institute of Healthcare Management said: "The NHS will only flourish in an atmosphere of openness where whistle blowing is always encouraged and people feel comfortable raising issues.

"Successful organisations have open cultures and they are better places to work in for it."

NHS response

If managers fail to live up to the standards expected of them, they can be dismissed

Nigel Crisp

Nigel Crisp, chief executive of the NHS, said conserted efforts were under way to improve the service.

"Where managers have shown they can deliver results we are prepared to lift the hand of Whitehall and give them more freedom to improve services locally.

"But we have seen in the past a tiny minority have failed to live up to the standards of the majority - in manipulating waiting list figures, for example.

"On Wednesday I will be launching a Code of Conduct setting out the ethics and standards by which all NHS managers will be expected to abide.

"This is the managerial equivalent of the 'Hippocratic Oath' taken by doctors and clinicians, and states that all managers must make the care and safety of patients their first concern.

"But like doctors, nurses and other staff, if managers fail to live up to the standards expected of them, they can be dismissed."

The findings come ahead of the IHM's annual conference in Torquay which starts on Monday.