Health Secretary Jeremy Hunt has unveiled a stream of measures designed to restore confidence and trust in the National Health Service, including monthly reporting of ward-by-ward staffing levels.
Addressing parliament, Hunt said “it is impossible to deliver safe care without safe staffing levels”, and so hospitals will be required to analyse how many shifts meet safe guidelines. By the end of this year, this is to be done with models independently approved by the National Institute for Health and Care Excellence (NICE).
NHS Confederation director of policy Johnny Marshall has welcomed “the development of evidence-based tools and guidance for trusts to help them set staffing levels that are appropriate to the needs of their patients, while the publication of staffing levels will ensure greater transparency and give reassurance to patients and carers”.
However, “crude national ratios around nursing numbers risks hitting the target, but missing the point,” he warns, explaining “it would be possible for wards with seriously ill patients to meet the ratio, while having insufficient or the wrong mix of staff to actually meet patient needs”.
In its full response to the £13-million Francis inquiry, triggered after failings at Mid-Staffordshire hospital caused up to £1,200 avoidable patient deaths, the government has backed the majority of 290 recommendations made by the report.
The moves are designed to tackle a culture described by Francis as cost-cutting and target-chasing, and help push quality of care to the forefront of NHS priorities.
Actions to boost safety and openness include: monthly reporting various safety measures, quarterly reports of complaints data and better reporting of safety incidents, a statutory duty of candour on providers, liability for any trusts that have not been open with a patients, a new national patient safety programme and the development of a dedicated hospital safety website for the public.
Criminal offence of neglect
Elsewhere, the government has recommended a new criminal offence for wilful neglect, through legislation to enable that those responsible for the worst failures in care are held accountable.
But the Royal Pharmaceutical Society stressed that “patients and the public must be assured that any new criminal sanctions put in place for health professionals are balanced with laws and regulations that enable professionals to be confident that their concerns around for example, staffing levels, are listened to and acted upon”.
“It would be completely unacceptable for organisations to “scapegoat” individuals rather than addressing wider system failures such as those that occurred at the Mid Staffordshire NHS Trust,” it said.
Hunt also announced that every hospital patient will have the names of a responsible consultant and nurse above their bed, as well as a named accountable clinician for out-of-hospital care for all vulnerable older people.
Describing the measures as “a blueprint for restoring trust in the NHS”, the health secretary said that every patient in every hospital should have confidence that they will be given “the best and safest care and they way to do that is to be completely open and transparent”.
