Clearly dissatisfied with the findings of countless annual surveys, targets and inspections, audit-hungry hospital managers in the West Country have hit upon what they believe is a more accurate indicator: chocolate.

Bemused staff have been instructed to complete a “chocolate audit” of gifts that they have received from grateful patients — from boxes of Milk Tray and bottles of wine to cards and flowers.

Every time a nurse receives a present — a “gesture of gratitude” — they are now required to fill out a form stating what it is, who it is from, and how much it is worth. While managers at Royal Cornwall Hospital NHS Trust claim that the audit provides a good picture of patient satisfaction, the move has been criticised by staff representatives and health watchdogs for increasing the burden on overworked staff.

Managers said that the “gestures of gratitude” count is already helping to refine hospital care. Records in 2004-05 for the trust’s three acute hospitals — in Treliske, Penzance and Hayle — reveal that there were 8,000 gestures of gratitude, including gifts and letters. There were, however, 316 complaints.

“Keeping records of how many boxes of chocolates and thank you cards we get might seem trivial and a waste of time,” a spokesperson said.

“But such gestures are a good way of measuring patient satisfaction and receiving feedback. We also carry out patient surveys.

“It’s important staff know their efforts are appreciated by the public, and it doesn’t take very long to carry out.”

But the scheme, which is also up and running at Derriford Hospital, a part of Plymouth Hospitals NHS Trust, has not been universally welcomed. Jono Broad, of North Devon Patient and Public Involvement Forum, described the measure, at a trust that is £8 million in debt and facing 300 redundancies, as “management madness in the extreme”.

”If the staff don’t fill out the forms recording the gifts they get into trouble with management,” he said.

“They have to record how much the gift is worth, who it came from and then it’s all shoved in a cupboard.”

Nursing leaders also dismissed the idea. Howard Catton, head of policy at the Royal College of Nursing, said that keeping a log of gifts was “about as useful as a chocolate teapot”. “The process of auditing performance in a hospital is crucial but trying to do so by counting biscuits is completely useless,” he said.

A spokesman for Unison, the public sector trade union, described registering gifts as an unfathomable waste of time.

She said: “Nurses need to spend all their available time with patients, carrying out their duties. Visit any hospital and you will see nurses rushing around with enough to do.

“They work exceptionally hard and that is the true measure of performance, not who decides to give them a box of Maltesers.”

BELT-TIGHTENING

ROYAL CORNWALL HOSPITALS NHS TRUST

• £8 million in debt at end of past financial year

• Set to cut 300 of its 5,000 staff

  PLYMOUTH HOSPITALS NHS TRUST

• Needs to make savings of £22 million over coming years

• Set to lose 200 jobs

• Health chiefs say most cuts will be in “natural wastage” such as voluntary redundancies

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