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Mid-Staffordshire tragedy could make NHS stronger, says US expert Mid-Staffordshire tragedy could make NHS stronger, says US expert
(7 months later)
The NHS has the capacity to lead the world in patient safety if it learns from the Mid-Staffordshire tragedy, according to the US expert appointed by David Cameron to head a taskforce on improvements in the aftermath of the Francis report.The NHS has the capacity to lead the world in patient safety if it learns from the Mid-Staffordshire tragedy, according to the US expert appointed by David Cameron to head a taskforce on improvements in the aftermath of the Francis report.
Don Berwick, an acclaimed proponent of patient safety who headed Medicare and Medicaid – the safety net healthcare providers in the US for the elderly and the poor – between 2010 and 2011, said he was surprised and distressed by what happened at Mid Staffs.Don Berwick, an acclaimed proponent of patient safety who headed Medicare and Medicaid – the safety net healthcare providers in the US for the elderly and the poor – between 2010 and 2011, said he was surprised and distressed by what happened at Mid Staffs.
"Mid Staffs was a tragedy and any feeling human being is brought to tears by what these patients and families went through. I don't want anything I say to minimise my sense of concern and alarm for such a tragedy. It is a very large tragedy – but a bit surprising. The NHS has quite a distinguished record as long as I've know it, which is about 20 years now, of progress toward improvement, including some very good focus on patient safety in parts of the service."Mid Staffs was a tragedy and any feeling human being is brought to tears by what these patients and families went through. I don't want anything I say to minimise my sense of concern and alarm for such a tragedy. It is a very large tragedy – but a bit surprising. The NHS has quite a distinguished record as long as I've know it, which is about 20 years now, of progress toward improvement, including some very good focus on patient safety in parts of the service.
"Healthcare is a very complex endeavour. Safety and quality are not automatic. They require the attention of leaders at all levels. Without that, risk grows. Things really did seem to get out of control in a way that is really incredible.""Healthcare is a very complex endeavour. Safety and quality are not automatic. They require the attention of leaders at all levels. Without that, risk grows. Things really did seem to get out of control in a way that is really incredible."
Berwick, co-founder and president emeritus of the Institute for Healthcare Improvement in the US, will head a panel including experts from the US and the UK, called the national advisory group on the safety of patients in England, which will report to the National Commissioning Board and the Department of Health at the end of July.Berwick, co-founder and president emeritus of the Institute for Healthcare Improvement in the US, will head a panel including experts from the US and the UK, called the national advisory group on the safety of patients in England, which will report to the National Commissioning Board and the Department of Health at the end of July.
"I see our charge as partly retrospective – to carefully study what the Francis report says, the information and the conclusions about what happened," he said. "But much more importantly than that, I think our charge is what to do now, what to do next, not just for Mid Staffs of course but for the NHS as a whole that will be scientifically grounded and respectful of what we know about the dynamics of patient safety so that the country can take even further steps – big ones – toward improvements and modifications.""I see our charge as partly retrospective – to carefully study what the Francis report says, the information and the conclusions about what happened," he said. "But much more importantly than that, I think our charge is what to do now, what to do next, not just for Mid Staffs of course but for the NHS as a whole that will be scientifically grounded and respectful of what we know about the dynamics of patient safety so that the country can take even further steps – big ones – toward improvements and modifications."
Berwick sees the pursuit of safety as a continually evolving job, he said. "You are never done. Yes – there needs to be change in the entire NHS so that safety continually improves."Berwick sees the pursuit of safety as a continually evolving job, he said. "You are never done. Yes – there needs to be change in the entire NHS so that safety continually improves."
It is not possible to prevent all harm to patients, "but a safe system tries to build dykes," he said, "for protection against our own frailties. I do believe it is quite correct to have the attitude that no harm is acceptable. I think it is an inspiring thought and not impossible that the NHS over time could be a world leader on patient safety."It is not possible to prevent all harm to patients, "but a safe system tries to build dykes," he said, "for protection against our own frailties. I do believe it is quite correct to have the attitude that no harm is acceptable. I think it is an inspiring thought and not impossible that the NHS over time could be a world leader on patient safety."
Berwick says there is much to admire in the NHS. "On the whole the NHS is a great achievement – universal care in a system that is accountable to its population and high levels of equity in the service," he said. In the past 15 years, there had been some remarkable achievements, he said, citing initiatives in primary care, cardiac care and accident and emergency. "It is not a perfect system and it needs to be improved. The good news is that it has the capacity and the human resources [to do it]."Berwick says there is much to admire in the NHS. "On the whole the NHS is a great achievement – universal care in a system that is accountable to its population and high levels of equity in the service," he said. In the past 15 years, there had been some remarkable achievements, he said, citing initiatives in primary care, cardiac care and accident and emergency. "It is not a perfect system and it needs to be improved. The good news is that it has the capacity and the human resources [to do it]."
Like all western healthcare systems, "it needs to improve in reliability and precision of care so that every single patient can be guaranteed that all care will be correct care and not subjected to care that is unhelpful." Patients and families needed help to be much more in control of what happened to themLike all western healthcare systems, "it needs to improve in reliability and precision of care so that every single patient can be guaranteed that all care will be correct care and not subjected to care that is unhelpful." Patients and families needed help to be much more in control of what happened to them
Berwick was Obama's recess appointment in 2010 to head Medicare and Medicaid but the Republicans in Congress refused to approve him and, after 18 months, he had no option but to resign. His downfall was said to be his praise of the NHS at its 60th birthday celebrations in London, although he told the Guardian in an interview last year that he also talked about the shortcomings of UK healthcare. His opponents in Congress, he believes, wanted him out come what may.Berwick was Obama's recess appointment in 2010 to head Medicare and Medicaid but the Republicans in Congress refused to approve him and, after 18 months, he had no option but to resign. His downfall was said to be his praise of the NHS at its 60th birthday celebrations in London, although he told the Guardian in an interview last year that he also talked about the shortcomings of UK healthcare. His opponents in Congress, he believes, wanted him out come what may.
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