Norman Lamb MP writes…The Better Care promise – driving up standards of care across our NHS

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

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9 Comments

  • I particularly like the ‘duty of candour’ and hope it will work in practice as intended. But while care for our most vulnerable citizens continues to be regarded as low-grade work there will continue to be problems at best, and appalling abuses at worst, I fear.

  • Eddie Sammon 19th Jul '13 - 1:06pm

    I can’t stand any veiled criticisms of the morals of NHS workers. If you have problems with individuals then name them, but don’t tarnish the whole profession and then introduce more bureaucracy.

    Your “Better Care Promise” talks about introducing “basic levels of care which can never be breached”, how? Are you going to enable hospital workers to grow a second pair of limbs when an employee is off sick? What happens if they do breach this level of care just once? Fired immediately?

    The government are introducing more inspectors, which could be a good idea, but to be extra critical I would say that hospitals are inspected by the public every day and they could do with more resources, not more inspectors.

    I’m trying to stick to commenting on articles rather than commenting on comments, so if people could not ask me questions that would be great. And I’ll try to do the same!

  • Eddie Sammon 19th Jul '13 - 1:11pm

    I’m sorry I’ve just seen this gem from the article that I missed first time around:

    “introducing new criminal offences for providers who purposefully publish false or misleading information about performance”

    If you are going to introduce this for providers then it should also be introduced for politicians too.

  • Eddie Sammon 19th Jul '13 - 1:29pm

    PS, I don’t mean to disrespect a minister, thanks for the work and writing on the site, it all doesn’t go without appreciation!

  • David Allen 19th Jul '13 - 5:55pm

    Black mark, Mr Lamb. 500 words of serious analysis. Not a single mention of how everything must come back to Labour having messed everything up. Off message, Mr Lamb. Any more articles like this, and people might even begin to think that you’re concentrating on trying to do a decent job!

  • “Not a single mention of how everything must come back to Labour having messed everything up. Off message, Mr Lamb.”

    It’s OK. He used the phrase “joined up” three times – “joined up approach”, “joined up thinking”, “Joined up patient care”.

  • Stephen Donnelly 20th Jul '13 - 5:38pm

    The FT presents a better analysis today . Their story is headlined ‘Conservatives seek to use NHS as their stick to beat Labour’.

    Conservatives briefed the press last weekend that there had been 13000 ‘excess deaths’ in 14 hospitals. Some parts of the press ran the story, notably the Mail on Sunday and Daily Telegraph. This line was pushed heavily before the publication of the Keogh report on Newsnight and Today by right wing academic Prof. Brian Jarman.

    Bruce Keogh described the 13000 figure as “clinically meaningless and academically reckless”. In fact death rates have fallen by over 30% over the last decade. The figures for ‘excess deaths’ are very controversial and not widely accepted within the medical profession.

    Clearly these attacks by the Conservative on the NHS are going to continue. Liberals should accept the need for reform, but distance themselves from the destructive nature of Mr Hunt’s policies.

    Norman Lamb’s article reads as if it has been written by a civil servant and fails to set out a liberal position. We appear to be meekly acquiescing to policies that few party members could support.

    The NHS will be a major battle ground and we must do much better than this.

  • Malcolm H. Mort 27th Jul '13 - 5:24am

    In the first case Mr Lamb needs to get into the real world. Mr Lamb needs to consider the damage and misery the Lib-Dems have caused to the health of sick and disabled people by supporting the Conservatives in their aims to exploit such unfortunate people to raise money to subscribe towards the payment of this countries debts. How could you people be so
    inept as to offer no opposition to the latest legislation with its massive adverse influence on the lives of sick people? In cases where elderly people are discharged from hospital after suffering strokes or heart attacks to be cared for at home
    by families , friends supported by Social Services, what happens if their house needs special alterations like a walk in shower, Special bed and nursing aids. Such things can cost in excess of £10,000. Where people live in flats I venture
    to ask what specially built housing does local councils have available to cater for such cases in the event of residents being unable to meet such costs. In other words what advance plans are local councils making to care for such people in their own homes. What about the skills in caring for severely disabled people and the insurance costs of meeting the
    accident liabilities?

  • Malcolm H. Mort 27th Jul '13 - 5:48am

    Mr Lamb needs to get into the real world and consider what is involved in caring for elderly disabled people with their problems. Take the case of a person having suffered a stroke or a heart attack being told he or she can go home to be cared for by their family or friends with the support of social services. However they live upstairs in a Council flat where there is no lift.. Let me say that the person requires a walk-in- shower. A special bed. This leaves me asking what facilities are local council considering in their new building plans? As for having a neighbourhood watch caring for disabled people I ask about the special skills, lifting, carrying and accident risks involved, requiring insurance cover!

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