Wednesday, March 27, 2013

What was unique in severity and duration in case of Mid Staffs?

The government initial response to the Francis report has been published. I still worry that Mid Staffs has been unfairly singled out (see previous post). I'm also not convinced that the new Chief Inspector of Hospitals can provide a "single version of the truth", if there is such a thing, in his or her so-called balanced assessment of hospitals. These matters are always open to interpretation. How this will be helped by inspectors "looking the [Trust] board in the eye" I'm not sure.

Nor am I clear what embedding "a zero tolerance of avoidable harm" in the DNA of the NHS means (see previous post). Harm may appear avoidable in retrospect but not necessarily so before it happens.

It's also good to reduce "paperwork, box ticking and duplicatory regulation and information burdens" but why by at least a third and how will we know whether that target has been met (aren't we supposed to be moving away from targets)?

Wednesday, March 20, 2013

Can zero harm be a reality in NHS?

Press release from the NHS Commissioning Board confirms that "Professor Donald Berwick is being brought to the NHS to chair a National Advisory Group on the Safety of Patients in England" (see terms of reference and members). David Cameron has asked Berwick "to make zero harm a reality in our NHS". At least he's appreciated that the Francis report needs to be put in the context of patient safety research (see previous post).

Berwick talks well (eg. see video on BBC website). He recognises that most healthcare staff intend well and I too want the NHS to be the safest in the world. But it's misleading to expect no errors in healthcare (see another previous post) and Berwick might need to refine at least his language. Being a doctor is not the same as being an airline pilot.

Berwick must be glad to have left the vitriol of US healthcare politics behind him (see Who is Don Berwick?) It's difficult to relate to some of the emotive language used there (see previous post). But UK healthcare politics too can be based on misunderstandings (see previous post). Hopefully, Berwick and his group can help take the Francis report forward in a sensible way.