Shake-up to make NHS ‘open and honest’

THE NHS in England needs to undergo a “profound transformation” to create a more open and honest culture, Health Secretary Jeremy Hunt has said.

Doctors or nurses who speak up about errors and problems at an early stage, would see their honesty used as a mitigating factor in any subsequent disciplinary hearing.

Mr Hunt outlined the challenges as he unveiled a raft of new measures in response to the public inquiry into the Stafford Hospital scandal.

From April, patients south of the Border will be able to see the numbers of staff working on wards on a safety website and see whether they meet recommendations to be set down in new guidance.

But the coalition stopped short of introducing a minimum staff-patient ratio on wards or enshrining this in law. The Royal College of Nursing had called for a minimum of one nurse to eight patients

Mr Hunt said the UK government would not introduce a legal minimum because staff requirements were a “different number for different wards”.

Getting hospitals to publish monthly data on ward staffing would be a “huge step” forward, he said, adding some of the problems at Stafford would have come to light with greater transparency.

The inquiry into the scandal at Mid Staffordshire NHS Foundation Trust, where between 400 and 1,200 more patients died than would normally be expected, put forward 290 recommendations. Chaired by Robert Francis QC, it identified a culture where patients were not at the heart of the system.

The coalition yesterday rejected just nine of its recommendations, including calls for healthcare assistants to be registered, saying training would be improved. There will also be no statutory duty of candour on individual NHS staff to tell patients or their families if incidents have led to serious harm or death.

Instead, the government will impose such a duty on organisations. Other measures to be introduced include professional codes of conduct to create a “common responsibility” for staff to be honest with patients when mistakes occur and for staff to report “near misses” that could have led to death or serious injury.

And doctors or nurses who speak up about errors and problems at an early stage, would see their honesty used as a mitigating factor in any subsequent disciplinary hearing.

It is likely NHS boards in Scotland will monitor developments with a view to adopting successful measures in future.

Mr Hunt said: “Nobody makes these mistakes intentionally but if you cover them up, lessons don’t get learnt.”

Under the plans, a “fit and proper persons test” will be introduced so managers who have failed in the past will be barred from taking up posts elsewhere in the system. Every patient will also have the names of a responsible consultant and nurse listed above their bed.

But Christina McAnea, head of health at the Unison union, said: “The government has missed another opportunity to introduce fixed, safe nurse-to-patient ratios.”

And Emma Jones, of law firm Leigh Day, which represented more than 120 victims of abuse and neglect at Stafford Hospital, said “We are disappointed a duty of candour has not been be extended to individuals.”

.Shadow health secretary Andy Burnham said nurse/patient ratios across the NHS in England had worsened in the last three years, with 5,890 fewer nurses.