The report from the Parliamentary Commission on Banking Standards will have made uncomfortable reading for government ministers and Treasury officials. But the news that the Care Quality Commission stood accused of covering up its own failure to investigate a maternity unit where babies died through neglect was a real shocker. Faith in the way healthcare organisations operate is a precious commodity. Patients, taxpayers and industry professionals have a common interest in making sure that steps are taken to reinforce the system’s natural safeguards and its intrinsic strengths.
As in Mid Staffs, it was patients and their relatives who exposed the underlying problems at Morecambe Bay, so it is important their voices continue to be heard. The NHS already wants to move in the right direction on this, by facilitating access to patients’ records, supporting improved feedback mechanisms, better patient information, and so on. But the private sector generally, and drug companies in particular, have valuable experience and expertise that could be put to good use.
Nearly nine out of ten (88%) adults polled across the UK say they trust doctors to tell the truth – and the clinicians responsible for the care of those babies certainly have questions to answer – but wider aspects of public accountability must be tackled by others. The same survey, by Ipsos Mori, told us that politicians remain the least trusted profession measured, with just one person in six (17%) saying they trust government ministers. So, it makes sense for GPs in charge of Lancashire North Clinical Commissioning Groups to take the lead in showing local people that their part of the NHS still has the best interests of individual patients at heart. After all it is part of the day job for clinicians, and the CCG is committed to developing a strategy called Better Care Together to look at how hospital services linking to wider health services in the community and primary care will work in the future. Those keen to fix the problem by applying solutions nationally should heed an old maxim that has proved its worth down the years: no-one cares how much you know, until they know how much you care.
The Commission on Banking Standards interviewed hundreds of witnesses, heard 161 hours of evidence, and posed more than 9,000 questions. One of the report’s most dismal findings noted a “striking limitation on the sense of personal responsibility and accountability of leaders for the widespread failings and abuses over which they presided” – an unwelcome but common symptom of malaise. The banking recommendations point towards changing the regulatory framework, with senior appointments requiring approval and enabling individuals to be punished for specific failures. While a ‘duty of candour’ is expected to keep NHS managers honest, a criminal offence of ‘reckless misconduct’ is envisaged for bankers. Such legal sanctions and procedures make for good speeches, but it is cultural influences that generally prevail. The new NHS chief executive being recruited to replace Sir David Nicholson therefore carries a heavy burden – they need to personify the ethos of public service.
The most practical countermeasure companies can take to prove their good faith may be to team up with CCGs who want help to introduce worthwhile changes. In short, joint working beckons as never before. Some good examples have been highlighted in a recent PharmaTimes competition, part of a networking event with a range of NHS organisations taking place on 12 July and followed by a Partnerships in Health awards ceremony to recognise the best partnership projects (see the September issue of PharmaTimes Magazine for more on this). It is an important part of promoting fresh thinking about how the NHS should really respond to service shortcomings and patients’ needs.