Whistleblowers must be encouraged in the NHS and a “duty of candour” must run throughout the health service, the Department of Health (DH) has said, in a policy announcement called ‘Protecting patients from avoidable harm’.
At the same time, it was announced that nurses will have to spend a year as healthcare assistants on wards doing basic care, including feeding and washing patients, before they can qualify. The aim is that compassion and care in hospitals should become just as important as targets.
The Health Secretary Jeremy Hunt said: “Frontline, hands-on caring experience and values need to be equal with academic training. These measures are about recruiting all staff with the right values and giving them the training they need to do their job properly, so that patients are treated with compassion.”
DH pointed that while things run smoothly for most of the 1m people who use healthcare services every 36 hours, things do go wrong and mistakes are made. Recent high profile cases show that there is still a lot to do to make sure that everyone is treated safely.
Although patient safety becomes the responsibility of the NHS Commissioning Board from next week, the department will continue to measure how successfully the NHS protects patients, using guidelines set out in the NHS Outcomes Framework 2012/2013.
A new measure will see individual cases reviewed to identify how many patients had problems in their healthcare. DH will also look at patient safety incidents that are reported, because reporting incidents shows that the NHS is open and learns from mistakes. It will also monitor serious patient safety incidents that are reported, incidents in which children are harmed because of a failure to monitor them properly, and healthcare associated infections.
The NHS also has a list of 25 ‘never events’ – incidents that can cause severe harm or death and that should never happen because there are tools to prevent them. Examples include operating on the wrong part of a patient’s body and leaving objects in a patient’s body after an operation. In 2011/2012, 326 never events were reported to strategic health authorities but DH wants to cut this to zero.
The department also said that it wanted to protect adults who may be vulnerable to abuse and neglect. Under the Care and Support Bill (soon to be laid before parliament), local councils will have to create a ‘safeguarding adults board’. These boards must produce a plan for protecting adults who may be vulnerable to abuse or neglect and who have care and support needs.
“It is important to learn from mistakes in health and social care and to prevent them happening again,” the new policy document said. “We have already set out the [actions we will take] after the Winterbourne View scandal. For example, people with learning difficulties, autism or mental health problems will get more support in the community rather than in hospital, where appropriate.
“We are also introducing a ‘duty of candour’ for NHS organisations – this means they must tell patients if their safety has been compromised, apologise and make sure that they learn lessons so that mistakes don’t happen again.
“[And] we expect all NHS organisations to have ‘whistleblowing’ policies and procedures. These allow staff to raise concerns about issues that are in the public interest without the risk of suffering at work – for example, victimisation or losing the chance to be promoted. We have therefore strengthened the NHS Constitution by including an expectation that staff will raise concerns and that their employers will support them, and by providing greater clarity about how the law protects them. [And we have] funded a helpline for health and social care staff who want advice on how to raise their concerns and employers who want to know how to meet their whistleblowing obligations.”