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NHS report urges 'cultural change'
Changing the culture of the NHS should 'trump' any new rules and strategies, a major review has said
Continually improving patient safety should "permeate every action and level in the NHS", according to a major review.
Changing the culture of the NHS will "trump" any new rules and strategies, said the study, from Professor Don Berwick, a world expert in patient safety.
He set out a series of measures, including criminal sanctions for staff who wilfully neglect patients and adopt a "couldn't care less attitude" which causes injury to the patient. He said: "Where there is wilful or reckless neglect of patients there needs to be consequences", but said sanctions should only be used rarely for 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.
The Government-ordered report said "achieving a vastly safer NHS will depend far more on major cultural change than on a new regulatory regime". Patient safety and quality of care should come above all other aims of the NHS, it said.
Prof Berwick said "nothing will be more important than the voice of parents and carers", calling on the NHS to end any "tokenism" on the issue of listening to what patients say.
He reiterated calls for a review of staffing ratios so wards are never too short of staff to care for patients. The National Institute for Health and Care Excellence (Nice) should come up with a formula that NHS leaders can use to check they have the right numbers of staff on their wards, he said.
Prof Berwick was tasked by Prime Minister David Cameron earlier this year with conducting a root-and-branch safety review of English hospitals. A former adviser to US president Barack Obama, he has said he believes the NHS could offer the "safest healthcare in the world".
He wants the scandal at Mid Staffordshire NHS Foundation Trust, where between 400 and 1,200 more people died than would normally have been expected, to act as a catalyst to drive improvements. Mid Staffordshire was at the centre of a public inquiry into Stafford Hospital, where hundreds of patients were routinely neglected. The findings prompted a separate review, led by NHS medical director Professor Sir Bruce Keogh, of 14 NHS hospitals in England with high death rates. As a result of that review, 11 hospitals were placed in special measures for "fundamental breaches of care".
Staff and organisations will face criminal sanctions only if "very, very stringent" criteria are met which establish "wilful or reckless neglect", Prof Berwick said. Accidental errors would not be subject to criminal prosecution under the new system. But organisations that mislead regulators or hide evidence would face criminal sanctions.