• Sir David Dalton urges health secretary to see patient safety as a “firm priority” for the NHS 
  • Warns progress made since Mid Staffs scandal could “easily atrophy”
  • Also criticises “dreadfully slow” process holding back capital investment

Sir David Dalton has urged health and social care secretary Matt Hancock to view patient safety as a “firm priority” for the NHS, warning progress made since the Mid Staffs scandal could quickly disappear.

In an interview with HSJ, the recently retired trust chief executive also criticised the “dreadfully slow” process that is holding back capital investment in some “dire” hospital facilities.

Sir David stepped down from Salford Royal Foundation Trust at the end of last month after leading the organisation for 18 years.

Among several suggestions for Mr Hancock and other national leaders, Sir David stressed the importance of staying focussed on quality improvements and patient safety.

Mr Hancock is best known for his enthusiasm for new technology, whereas his predecessor Jeremy Hunt styled himself as a patient safety champion.

Sir David said: “I would urge him [Mr Hancock] to stay the course on improvement and the focus on patient safety. So much has happened in the last decade that probably wasn’t imaginable two decades ago, and it’s fabulous to see….

“Wherever you go in the country now, people can talk about what they’re doing and what their method of improvement is. They know the metrics associated with patient safety, they’re still measuring pressure ulcers, infection rates and so on.

“There’s been enormous change because a decade ago it wasn’t like that. But these things can easily atrophy, and the benefits rapidly disappear.

“We have to ensure all staff have this sense that they are the ones that we want to drive improvement. I think that’s a signal that comes from the top of the organisation, whether you’re secretary of state, a regional director, the chief executive of a trust, or a ward manager….

“So, it would be good for the secretary of state still to say that this is a firm priority that he attached importance to. I’m sure if he was sat with us, he’d say ‘absolutely I agree with it’, but I think it always needs attention.”

Sir David said the “wrong signal” had been sent by the Department of Health and Social Care in ceasing to publish nurse staffing levels for each hospital in England, saying the “evidence is overwhelming that the proportion of registered nursing staff is a good proxy indicator for safe levels of care”.

But he added: “Every chief executive, every chief nurse should be saying ‘we will continue to be reporting this to our board… We will continue to pay attention to it because we think it’s important.’”

When he became health and social care secretary, Mr Hancock said his initial priorities for the NHS were workforce, technology, and prevention. In a speech last July, he added: “The patient safety agenda is important to me and I strongly believe properly integrated technology has the power to further enhance safety and improve outcomes for patients.”

Sir David, who has set up a consulting business, also urged national leaders to ensure capital funding reaches areas which need it more quickly.

There has been huge frustration in Greater Manchester about delays in getting final Treasury approval for a major reconfiguration of emergency services, known as Healthier Together, that was approved locally almost four years ago.

Sir David said: “One of the frustrations I’ve experienced in recent years has been the pace of decision making has been dreadfully slow. It takes the NHS a long time to reach a conclusion and in the end I found that incredibly frustrating in the work we were doing. The investment that we could see that was needed just wasn’t happening or arriving at the time we were expecting.

“I think if I was to urge the centre and secretary of state to do one thing it would be to look at ways in which you can get capital to the right places far more quickly that is happening at the moment.”

He cited North Manchester General Hospital as an example of some “pretty dire unloved estate”.

Sir David also called for more action to be taken to support social care, to get the NHS workforce plan right, and to get stronger and more capable NHS organisations to help others.

Sir David was one of the longest serving chief executives in the provider sector and was HSJ’s chief executive of the year for three successive years to 2016. He also stepped down as chief executive of Pennine Acute Hospitals Trust last month, which he led for three years and is set to be acquired by Salford Royal under the Northern Care Alliance.