Thursday, 29 August 2013

This week in healthcare: 5-9 August

David Cameron in A&E Struggling A&E departments are to be given a £500m bailout to help relieve pressure in the coming months. Photograph: Getty Images

Welcome to our weekly roundup of healthcare news from around the web.

The big healthcare story this week was the final publication of a review of patient safety in the NHS by acclaimed US expert Don Berwick. It was expected to recommend legal duty for doctors, nurses and other health workers to admit mistakes.

When released, it said that the system was to blame for NHS mistakes, not staff. As the Guardian reported, the review said:

Even while leaders speak out clearly and with courage, as they should when things go wrong, it is helpful to avoid drama, accusation and overstatement either in the Mid Staffordshire case or in other lapses in patient safety. No single person, party or administration caused the problems that need to be solved and everyone can help guide the next steps if they work together.

The Telegraph reported that NHS staff could be prosecuted for "reckless neglect" of patients. The review called for a new criminal offence to be created, so that those who deliberately or carelessly inflict patient harm could be punished. It has also said new national guidance on safe staffing levels should be drawn up by the National Institute for Health and Care Excellence, which all hospitals should follow.

In a video interview for the Guardian, Berwick said that NHS bosses should focus on listening and transparency:

Link to video: Berwick report: NHS bosses should focus on listening and transparency

The BBC ran a video of Jeremy Hunt responding to the review findings.

Guardian health editor Sarah Boseley reported that Berwick had called for the NHS blame game to end, with leaders fostering a more positive working culture.

A Guardian editorial on the report labelled the NHS a "fine institution":

If incentivising by praising what's good is as important as Professor Berwick believes, then his report should transform the health service in England. But he has disappointed the government by dismissing zero-harm as an achievable objective, and he has disappointed campaigners by providing no shiny new levers to translate his ambition. There's to be no reform by statute but instead change through leadership, candour and transparency. He suggests only the most sparing use of the law, which should be reserved for the most extreme examples of calculated neglect, something he plainly believes is rarely found in an organisation that he cherishes as "a world-leading example of commitment to health and healthcare as a human right".

Boseley claimed that there was a tough stance on regulation amid the Berwick review's goodwill proposal.

On one issue he is prepared to be tough, believing regulation in the NHS is a mess. Personally he would like an immediate inquiry with a view to forcing the CQC, Monitor and the NHS Trust Development Authority to work together or even turn into a single body. His committee, perhaps conscious of recent CQC turmoil and demoralisation, says it should happen in 2017, or sooner if they do not start collaborating. That puts the government on the spot, as does his insistence that leaders (including ministers) must not blame NHS staff for mistakes. If there should be another Mid Staffs, who now will take the rap?

BBC health correspondent Nick Triggle, meanwhile, asked: How many reviews does the NHS need? He wrote:

After the flurry of reports and recommendations of recent months, the NHS will be after some clear direction from ministers once their holidays are over and Parliament resumes in September.

Sarah Wollaston, a former GP and now Conservative MP for Totnes, wrote for the Telegraph explaining why a culture of fear and blame won't fix the NHS. She said the best way to improve safety in the health service is to make the staff proud of what they do.

• In other news this week, A&E departments are to be given a £500m bailout in a bid to avert crisis. The BBC reported that the bailout was only 'papering cracks'. Roy Lilley wrote for Guardian Comment is Free asking: What will the A&E injection really be spent on? He believes much of the £500m given to the NHS to fend off another winter crisis will probably go on agency and locum fees and social care:

Despite the hype, the criticisms and some self-inflicted stupidities, hospitals are run by experienced, thoughtful people who will do their best to make sure we don't have another winter like the last one. My guess is, whatever the weather, it will still be hot in A&E.

• In the Telegraph, Andrew Lawson claimed: "If I'd relied solely on the NHS to treat me, I might well be dead". He believes that the NHS was unable manage his cancer properly. Dan Poulter, parliamentary under secretary of state for health, argued that the NHS needs a "Bargain Hunt approach" to procurement, saving money on everything from surgical gloves to hip replacements.

• Peter Wilby, former editor of the Independent on Sunday and the New Statesman, wrote for Guardian Comment is Free on the risk that the NHS will fail so long as we consider healthcare a market. He said the health service is saddled with impossible expectations; when it doesn't meet them, yet more 'reform' is prescribed:

The first duty of the NHS is to make patients well – or, at least, less sick – not to pander to "consumer preferences". Almost all would settle for that, just as most parents would sacrifice school choice for a decent school in their neighbourhood. The miracle is that Berwick's report can conclude that the NHS is not "unsound in its core". The vast majority of staff, clinical and non-clinical, are dedicated to helping their patients, he says.

• In the Health Service Journal, Don Redding, director of policy at National Voices, asked whether patient rights have any meaning today?

• Michael Dixon, chair of the NHS Alliance, featured on a King's Fund video discussing the value of volunteering in health and social care.

• Health secretary Jeremy Hunt blogged for Conservative Home, stating that "nothing should matter more than patient safety in the NHS". He wrote:

For too long, patient safety has been a secondary concern in parts of the NHS and this has to change. Every patient should have confidence that their care will be safe. Every member of NHS staff should feel supported to make safe, high quality care the priority. This government will make the NHS the world leader in patient safety which our patients deserve.

• On the Health Care Blog, Richard Gunderman tracked the "rise of the hospitalists" – physicians who only care for hospitalised patients - in the US. Could this trend be mirrored here in the UK?

Here's a run through of the rest of the week's healthcare news and views:

• The Guardian: Hospital needless deaths figure 'misleading'
• Chris Hopson: the NHS could keel over in 2016
• I'm an NHS boss … get me to the frontline
• The Telegraph: How Jeremy Hunt is following head boy Michael Gove's lead
• HSJ: Berwick chief: review critics 'miss the point'
• Pulse: Private companies set for access to patient data for just £1
• GP Online: GPs in CCGs investigate A&Es for first time over patient safety fears
• The Independent: Fit to work? Concern over contract paramedics sleeping in tents between shifts
• BBC: NHS gets own price comparison website

Here's a round up of the most read pieces on the Healthcare Professionals Network:

• Gap in perinatal mental health services needs urgent attention
• 'You'll always make mistakes ... it's about correcting them before they become really big'
• Dementia-friendly communities can improve care and save money
• 'Too much reassurance is dangerous for the NHS'

If there's something you particularly enjoyed reading this week, please add a comment below or tweet us @GdnHealthcare


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