NHS managers, doctors and nurses can expect to be put under greater scrutiny over the next two years in order to ensure better and safer care for patients.
The government’s mandate to the NHS, published today, makes repeated references to the NHS needing to become one the best health services in the world in terms of patient outcomes.
The document, which will set the NHS Commissioning Board’s priorities, has a large focus on culture, values and tackling variation in service quality.
This approach is not surprising given the arrival of what is predicted to be the publication in early 2013 of a highly critical report by Robert Francis QC into the care failings at Mid Staffordshire Foundation Trust.
The mandate talks of failures such as those at Mid Staffordshire as “abhorrent and intolerable”.
To bring about a cultural change the mandate says NHS managers will be “better held to account” when such failures occur.
At health secretary Jeremy Hunt’s request the Care Quality Commission is already investigating how to achieve this and the Professional Standards Authority published its own set of standards for NHS boards earlier this month.
But the mandate appears to recognise improvements in care standards must come from the whole workforce.
It suggests the commissioning board will encourage the “systematic development of clinical audit and patient-reported outcome and experience measures”, meaning clinicians can expect an even greater focus on their own performance.
Research has shown weekend death rates in hospital can be higher than those for weekday care, with a suggestion this can be due to a lack of consultant and senior doctor cover.
The mandate appears to back the growing move towards seven-day hospital care when it says: “The NHS should be there for people when they need it; this means providing equally good care seven days of the week, not just Monday to Friday.”
There is also recognition that quality of care is linked to how well organisations “engage, manage and support their own staff”.
The mandate also suggests staff could be asked for their own opinions about their organisation and its standards of care more frequently than the annual question included in the staff survey.
The mandate says: “The board should ensure that much more regular feedback on the friends and family test [from staff] becomes the norm” by March 2015.
New recruits and students will also not escape this focus on culture, with the mandate encouraging the commissioning board to work with the new education provider Health Education England “ensuring that the health workforce has the right values, skills and training to enable excellent care”.
HEE chief executive Ian Cumming has repeatedly said the new organisation and its £5.5bn budget exists to improve the quality of care.
In a direct comment on how it expects the commissioning board to operate the mandate says: “The scale of the ambitions in this mandate cannot be achieved through a culture of command and control.
“Only by freeing up local organisations and professionals, and engaging the commitment of all staff to improve and innovate, can the NHS achieve the best health outcomes in the world.”
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