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Health Committee calls for culture of openness in NHS

NHS should publish staffing levels on a daily basis

Jo Carlowe

Wednesday, 18 September 2013

Care quality needs to be a ‘natural’ part of the NHS culture not just ‘a duty which only arises in cases of service failure’.

This was the message from The Health Select Committee, which today published its report: After Francis: Making a difference.

Among the recommendations made by the Health Committee was the call for NHS care providers to publish data on staffing levels at ward level on a daily basis in a standard format designed to allow easy comparison against benchmarks.

The Rt Hon Stephen Dorrell MP, Chair of the Committee called for a cultural change that would make it easier for concerns to be raised about care standards and patient safety.

“Many who raise their concerns in the NHS at present risk serious consequences for their employment and professional status,” he said.

Adding: “The NHS standard contract imposes a duty of candour on all NHS providers. This is an essential principle, but it is not adequately understood or applied. It should mean that all providers create a culture which is routinely open both with their patients and their commissioners. The same principle should apply to commissioners so that they are routinely open and accountable to local communities.”

The Committee made it clear that the prime role of the Care Quality Commission (CQC) should be to encourage the development of this culture within care providers and for NHS England to develop the same culture within commissioners.

The report also announced that the Health Committee would work closely with the Professional Standards Authority to develop accountability processes for professional regulators in healthcare.

Commenting, Mr Dorrell said: "The NHS needs to be an organisation in which an open dialogue about care quality is part of the natural culture of the organisation, not a duty which only arises in cases of service failure.

“Robert Francis made 290 recommendations in his report, but in truth they boil down to just one – that the culture of ‘doing the system’s business’ is pervasive in parts of the NHS and has to change.”

In a wide ranging review of the Francis recommendations the Health Committee also concluded that responsibility for monitoring patient safety data and practice should be transferred from NHS England to the Care Quality Commission (CQC); that breaches of the proposed fundamental standards of patient care should be treated seriously and investigated thoroughly with a focus on analysis and remedy of the adverse circumstances that led to the breach.

The Committee also concluded that the responsibilities of the CQC and Monitor in operating the new single failure regime for providers would have to be very closely aligned.

Peter Carter, the Royal College of Nursing general secretary has given his backing to greater transparency on nurse numbers.

“The RCN has called for action to ensure there are safe staffing levels in all healthcare settings, and the committee highlights the importance of this,” he said.

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