NHS staff and organisation’s that ‘wilfully’ or ‘recklessly’ harm patients should face new criminal penalties, a major review said yesterday.
It also demanded legal sanctions against leaders in the NHS with a ‘couldn't care less’ attitude or who deliberately withhold information.
The review headed by Professor Don Berwick, a world expert in patient safety, said there have been repeated safety defects in the NHS with too many patients and carers suffering as a result.
It called for a culture of transparency that puts patient safety above targets, especially financial goals.
Continually improving patient safety should ‘permeate every action and level in the NHS’, said the review commissioned by the Government in the wake of the public inquiry into the Mid Staffordshire scandal where hundreds of patients were routinely neglected and died. Managers chasing financial targets were partly blamed.
The Berwick report set out measures including a review of staffing ratios to ensure that sufficient numbers are on duty at all times, and simplifying an over-complex regulatory system run by many different agencies.
The National Institute for Health and Care Excellence (Nice) should come up with a formula to help NHS leaders check that hospital wards are properly staffed, with research suggesting one registered nurse per eight patients, but locally implemented.
However, Prof Berwick said changing the culture of the NHS would ‘trump’ any new rules and strategies, and he stressed that accidental errors by staff would not be subject to criminal prosecution under the new system.
But organisations that mislead regulators or hide evidence would face criminal sanctions along with staff who wilfully mistreat or neglect patients causing serious harm or death. He said: ‘Where there is wilful or reckless neglect of patients there needs to be consequences.’ But it would affect ‘a very small number of cases’.
Prof Berwick stopped short of saying a duty of candour should be enshrined in law requiring NHS staff to report beliefs about serious incidents, saying it was already included in professional codes of conduct.
He also said it would be a ‘bureaucratic nightmare’ for staff to be obliged to follow an automatic duty of candour where patients are told about every error or near miss.
Prof Berwick, a former adviser to President Barack Obama, said most staff were trying to do their best.
But his report said supervisory regimes and regulation in the NHS should avoid ‘diffusion of responsibility’, adding: ‘When so many are in charge, no one is.’ There should be a review of such organisations including the much-criticised Care Quality Commission by 2017.
Campaigners warned the review was another in a long line of ‘navel gazing’ reports into NHS shortcomings with few practical answers.
But Health Secretary Jeremy Hunt said it was a ‘call to action’ for the NHS although he did not accept that a national staffing minimum was necessary.
He said there was a danger that hospitals would settle for achieving the minimum even though there would be times when they would need to go beyond it. Katherine Murphy, chief executive of the Patients Association, said the report was ‘heavy on platitudes but light on practical solutions’.
Roger Goss, of the group Patient Concern, added: ‘Unless the Government implements mandatory minimum nursing staff levels per ward and a duty for all staff to tell patients when their care goes wrong, staff will carry on as usual.’
Shadow health secretary Andy Burnham said: ‘All the experts are now telling the Government to get a grip on staffing levels. Over 800 nursing jobs were lost last month alone – now totalling almost 5,000 since the election.’
Niall Dickson, chief executive of the General Medical Council, said: ‘This important report puts safety first and, if implemented, will improve care and save lives.’
After reading I found myself agreeing with the article, because although we have a brilliant health service, it is let down by some who are either not trained properly or don’t really care about the patients care and should never have been employed.
However I do feel that the chief executives should also be warned and if needed charged as they whether they like it or not are responsible for all of the staff at their facility, and they should ensure that these staff are doing their jobs properly. As an Engineer I was responsible for all who worked under me, and also had a role in ensuring they did their jobs properly and that should also happen in the hospitals etc.
A duty of care is part of nursing and also a major part of the doctors role, and neither should ever be allowed to forget it.
Yes some patients can cause stress and extra problems. but life would be dull if every patient was the same as the next.
Dementia patients can also be hard to work with as they need more care and attention, but the staff should be trained to cope with all patients these days.
This could also have a knock on effect where people decide that if there is a risk of being prosecuted at work they may not want to go into the job, but as in all jobs these days like my own there was also the risk of prosecution so its nothing new, it just keeps your mind focused.