It is clear that no single institution has done more to improve people’s lives than the NHS, and its generosity and expertise is something of which we are rightly proud. Yet events which have come to light, such as the abuse of people with learning disabilities at Winterbourne View or the grave neglect of patients at Stafford Hospital, have highlighted serious problems within our health service.
This week in particular we have seen the publication of two key independent reviews on NHS care, both of which highlight areas in need of urgent improvement. The outcome of the review by Baroness Neuberger into the ‘Liverpool Care Pathway’ (LCP) published its recommendations on Monday; it found that while the LCP is intended to make a patient’s final days as comfortable and pain-free as possible, it is too often badly implemented, which has led to some appalling failures in care. On Tuesday the Government also published the findings of the review by NHS Medical Director Sir Bruce Keogh into hospitals whose high-mortality rates indicate avoidable patient deaths. Of the 14 Trusts investigated by Sir Bruce, 11 have been placed on special measures following evidence of serious poor practice.
I am absolutely clear that the Government must take action to ensure that the tragedies highlighted by these reports – as well as by the Francis report into the failings at Mid Staffordshire NHS Foundation Trust – never occur again. We have a duty to ensure that every patient is treated with the dignity and respect that they deserve, and that family members can feel reassured that the right decisions are being made for their loved one. That’s why I am championing the Better Care Promise, which embodies the Government’s commitment to tackling problems in the health service through a number of key measures to drive up standards of care.
Fundamentally, the Better Care Promise is about putting patients back at the heart of the NHS. We are achieving this in three key ways:
Ensuring people are treated with the dignity and respect that they deserve
- New fundamental standards in care homes so that all care providers are clear on the basic levels of care which can never be breached;
- Three new chief inspectors – of hospitals, social care and General Practice – to ensure that these new minimum standards are maintained;
- Compulsory training for healthcare and care workers, so that they are fully equipped to deliver high quality patient care;
- Reforming palliative care in light of the recommendations of the Neuberger review; we will replace the LCP with personalised end-of-life care plans backed up condition-specific guidance, in which every patient is assigned a single senior clinician in charge of their treatment.
Encouraging a joined up approach to care
- Making sure that no one falls between gaps in the system by encouraging joined up thinking between health and social care providers.
- Ten ‘integration pioneers’ will be chosen from among health and care organisations already taking innovative steps in the field of integrated care. These pioneers will form the inspiration for widespread change across the health and care services.
Improving transparency in the health service and holding managers to account
- Ensuring that hospitals and care providers are open and honest about their performance so that problems can be rectified as quickly as possible;
- Improving support for whistleblowers by introducing a ‘duty of candour’ for all hospitals and care homes and introducing new criminal offences for providers who purposefully publish false or misleading information about performance;
- Making it easier for the independent regulator the Care Quality Commission (CQC) to prosecute providers for serious failings and requiring directors of health and care providers to pass a ‘fit and proper person’ test.
- In light of the Keogh review, all Trusts placed on special measures will be required to implement a strict improvement plan with the help of a turnaround team who will publicly track their progress.
The steps being taken by this Government to drive up standards in our health and care system will ensure that every patient receives the high quality care they deserve. There are so many hospitals and health organisations that already carry out admirable work in patient care, yet those few examples of appalling failures indicate a serious need for change across the board. Historic problems have come to light which are deeply entrenched in the service as it stands, and the Coalition is committed to tackling them for the future. Through the Better Care Promise we are implementing basic universal standards for joined up patient care, ensuring better support and training for staff, encouraging honesty and transparency across all hospitals and Trusts and, most importantly, putting patients back at the heart of our health service.
* Norman Lamb MP is Liberal Democrat Minister of State at the Department of Health