Patient safety crisis: Jeremy Hunt unveils plans for NHS 'culture of openness' in wake of Mid-Staffs scandal

Measures include a named consultant and nurse responsible for every patient and publication of staffing levels and safety standards

The Government has unveiled its plans for a 'profound transformation' of the NHS, aimed at addressing concerns over patient safety in the wake of the Mid Staffs crisis.

Speaking in Parliament today, Jeremy Hunt said all trusts would have a 'statutory duty of candour', requiring nurses and doctors to be open in reporting any incidents in hospitals which have led to death or serious injury. 

NHS hospitals will be publicly rated on how safe they are by a new website listing the number of nurses on wards, the length of their shifts and when “never events” are allowed to happen.

Bosses will be required to set levels for staffing which are defined as safe by the NHS’s chief nurse, while trusts will be made to conduct open examinations on whether standards are being met.

And the plans state that every patient should be given the names of a responsible consultant and nurse, listed above their beds.

The new measures will come into effect from next April, and have been drawn up by the Government as part of its formal response to the Mid Staffordshire NHS Foundation Trust Public Inquiry.

Mr Hunt said the NHS had looked at the airline industry, where it was normal culture to report issues or near-misses.

He said: “We want doctors or nurses to think it's in their interest to speak out if there's something that worries them.

“We want a signal to go out to every trust board and chief executive in the country, to every doctor and nurse - if you are in any doubt at all, report.”

Mr Hunt said there was opposition to legal minimum staffing levels from several organisations, including the British Medical Association (BMA).

“The reason is that it's a different number for different wards. We decided the best way of tackling this was to require all hospitals to collect their staffing levels on a ward-by-ward basis.

“That will be a huge step and means people will know whether some of the problems that happened at Mid Staffs - which didn't happen throughout the hospital, which happened on particular wards - it will be possible to identify that through transparency.”

Mr Hunt told the Commons that cruelty became the norm at Stafford.

He said: “One of the most chilling accounts of the Francis report came from Mid Staffs employees, who considered the care they saw as being normal.

“Cruelty became normal in our NHS and no-one noticed.”

Health Minister Norman Lamb said he wanted to see the NHS become a “world leader in patient safety”, in the wake of the crisis at Stafford Hospital which saw up to 1,200 people die needlessly after they were “routinely neglected”.

An inquiry into those shortcomings led by Robert Francis QC made 290 recommendations to be carried out by healthcare providers and the Government – one of the most important being that the National Institute for Health and Care Excellence (Nice) should set out how many staff are needed on any type of ward at any time.

While the Government's response to the inquiry does not call for safe staffing levels to be set at a national level, it does call on hospital boards to set levels locally using guidance issued by NHS England's chief nurse that tells them what safe staffing looks like, a DH spokeswoman said.

She said that Nice will create guidance on the matter at a later date but will not suggest minimum staff to patient ratios.

The Care Quality Commission will inspect trusts and make sure they have the right numbers of staff, she added.

Patients will be able to see their hospital's staffing levels on a new patient safety website. The new national safety website will include data on staffing numbers and other safety indicators including information on the number of “never events” - events that should never happen in the health service such as a surgeon operating on the wrong part of the body or leaving medical kit inside of a patient.

And NHS England is to appoint 5,000 “patient safety fellows” who will be champions in patient safety, she added.

Jane Cummings, NHS England's chief nursing officer, said: “We have a very clear evidence of a link between appropriate staffing and the outcomes of our patients. This evidence must be used to set staffing levels locally.

”Patients and the public are therefore entitled to know that we have the right number of people in place to provide safe, quality care every time.

“We first encouraged a move towards greater transparency on staffing levels in my nursing strategy, but we are now going further. Hospitals will have to publish this information - at ward level - and present the evidence they have used to determine staffing levels in public.

”That is the right way to ensure there is rigour around decisions that are taken, as well as to provide hospitals and other services with the flexibility they need to get the right staff in the right place. We need the right level of staffing in every locality - and that cannot be mandated centrally.“

The news comes as Health Education England reported that NHS hospitals are planning to recruit 3,700 more nurses by the end of the financial year.

Health Minister Norman Lamb said: ”We are determined to see the NHS become a world leader in patient safety - with a safety ethos and level of transparency that matches the airline industry. The Francis report is already having an effect, with the NHS planning to hire more than 3,700 extra nurses over coming months.

“Experts know that the right number of staff varies by ward and by shift, and should be based on evidence. We need transparency on staffing levels, backed up by a strong inspection regime to get better, safer care”.

The Government's initial response to the Francis inquiry saw the introduction of Oftsed-style ratings for hospitals handed out by a new Chief Inspector of Hospitals. Health Secretary Jeremy Hunt also announced there would be a national black list of failing hospital bosses and proposed a “statutory duty of candour” for NHS providers so patients are fully informed when something goes wrong with their care.

Ministers also commissioned Professor Don Berwick, former healthcare advisor to president Barack Obama, to perform a review of safety in the health service.

Prof Berwick said: “The best keys to health care safety do not lie in blame, regulation, or punishment, but rather in learning, support, and encouragement to the health care staff, the vast majority of whom are dedicated to excellence in care.

”Leaders who aim for safe and effective care have a duty to supply the workforce with the tools, knowledge, and encouragement to do the work that adds meaning to their lives.“

Labour's shadow health secretary Andy Burnham said: ”There are today close to 6,000 fewer nurses in the NHS than when this Government came to power. As a result, too many hospitals in England do not have safe staffing levels.

“We have repeatedly warned the Government about nurse numbers falling to dangerous levels. This new focus on recruitment is overdue but it shouldn't have taken this long and it won't be enough to repair the damage of three years of falling nurse numbers on David Cameron's watch. He is allowing the NHS to go into a dangerous winter with a shortage of nurses and with increasing numbers of older people being admitted because of this Government's deep cuts in social care.”

Additional reporting by PA

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