Constitution review set to promote compassion and evidence-based commissioning

An expert panel is reviewing the NHS Constitution and is expected to report to the Department of Health in coming weeks. The DH will then consult on changes to the document. The work is expected to form part of the response to the public inquiry into the Mid Staffordshire Foundation Trust scandal, which is due to report to the health secretary next month.

The chair of the panel, the GP Steve Field, told HSJ universities should interview all healthcare staff before giving them places, and use the values in the constitution as part of the interview. He said the review had discovered that at present several nursing schools in England did not interview prospective students at all.

He said: “Universities should be interviewing all health care professionals not just offering them courses based on their A-Level grades. I despair of nursing schools and medical schools which don’t interview.

“[Without interviews] they can’t even role-play being caring and compassionate. If you can’t do that what hope have you got? The constitution should be part of the interviewing exercise.”

Professor Field said the constitution should also strengthen the rights and conditions of nurses and other staff. It should help ensure they are properly valued and regularly appraised.

He said: “What doesn’t come across clearly enough [in the current NHS Constitution] is that healthy, motivated, inspired staff make for far better compassionate care.

“We need a new principle for the NHS which values staff. Some feel stuck and don’t feel they have control over their lives and jobs.”

He also said healthcare employers should also use the constitution’s values in interviews for all staff, and was particularly relevant for non-registered staff, including healthcare assistants.

Professor Field, who has also been appointed as one of the NHS Commissioning Board’s two deputy medical directors, with responsibility for inequalities, said that role would also involve using the constitution to improve services for disadvantaged groups.

He said inequalities in outcomes were currently “a disgrace”.

He said, for example, the constitution could potentially create a commitment to giving “evidence based care”. That would mean all groups have an entitlement, and also prevent commissioners from unjustly limiting access to services.

Royal College of Nursing policy director Howard Catton, who is also on the expert review group, said: “There is a strong theme [from the review] that happy staff gives happy patients. If you get it right for staff you get it right for patients.

“If you get it right for staff you get it right for patients. Staff should feel values, respected, be treated with dignity and involved in decision making.”