How many reviews does the NHS need?

Files The Berwick Review is just the latest in a series of reports on the NHS

NHS reviews are getting a bit like buses. Miss one and you don't need to wait long for another to come round the corner.

A month ago there was the Cavendish Review into healthcare assistants, and then two weeks later the Keogh Review into mortality rates, which led to 11 trusts being put into special measures, was published.

Now it is Prof Don Berwick's review on patient safety.

All three were commissioned off the back of the Francis Inquiry into the Stafford Hospital scandal.

Once again, it has been met with the usual platitudes.

But there is also a sense that the time for talking is coming to an end: action is what is needed.

Responding to publication of the 45-page safety review, the Unison healthcare union said there was "no time to waste".

Meanwhile, the choice and empowerment organisation Patient Concern dismissed Prof Berwick's report as "long on what is needed but short on how its recommendations will be made to happen".

That may seem a little harsh. After all, Prof Berwick is perhaps the world's leading expert on patient safety.

Continuing confusion

But Patient Concern's exasperation is perhaps a sign that greater clarity is needed.

The Francis Inquiry made 290 recommendations. The three follow-up reports have brought that number to almost 500 and there is still a fourth, on complaints handling, to come.

And yet there is still confusion over what the government is doing on issues such as minimum staffing, criminalising neglect, improving nurse training and introducing a robust system of oversight for healthcare assistants.

It is true that there have been some changes. A chief inspector of hospitals has been appointed and a new inspection regime starts next month.

But after the flurry of reports and recommendations of recent months, the NHS will be after some clear direction from ministers once their holidays are over and Parliament resumes in September.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 70.

    My NHS transport department is using hired vehicles.
    This costs more than buying their own vehicles due to the large discount they would get on new vehicles.

    There is also a private company waiting to take it over by under cutting it.

    This is how the NHS is being privatised.

    Complicit managers not using cost effective means, so the NHS is costing more than it should.

  • rate this

    Comment number 69.

    I think you'll find that a blackhole is something that things disapear into and you get nothing out of, whereas lots of money goes into the NHS but we get one of the best performing health care systems in the world out of it and it really isn't that expensive if you look at western health care systems. Google if you're interested in the facts rather than government propoganda

  • rate this

    Comment number 68.

    The problem with all these reviews, NHS and elsewhere, is that their recommendations are never costed.

    Interested parties demand all recommendations are implemented, and we taxpayers have to pick up the bills.

    Good ideas perhaps, but without costings are they all really worth implementing?

  • rate this

    Comment number 67.

    How much do each of these reviews cost?

  • rate this

    Comment number 66.

    It's the jobsworth managers that are to blame, caring not for the sick but for themselves and their bank accounts. We have seen it time and time again, too many chiefs not enough Indians. (no offence meant)

  • rate this

    Comment number 65.

    The problem with almost all government "reviews" is that they tend to be stacked to support the governments view. If, heaven forbid, the review goes "off-message" then it will be dismissed and canned.

  • rate this

    Comment number 64.

    @ Actually, it's my 3rd post! All were removed! My point is really against the BBC and its inconsistency!

    The NHS is a financial black hole, remember the PFI payments anyone??
    1st was removed before I could read it. Your comment was grossly offensive towards NHS staff and did nothing to support your argument of bias. I agree with you its blackhole but an NHS is worth paying for. Look at USA.

  • rate this

    Comment number 63.

    Endless interference by politicians, swayed by their own ideology rather than anything to do with evidence based change or knowing how to run a complex organisation is what is killing not only the NHS but public services generally including education. I doubt any private sector organisation could operate with that level of outside interference but they all want to get hold of the tax payer's dosh.

  • rate this

    Comment number 62.

    We have apparently concluded (after 65 years) that patient safety should be the NHS's top priority.

    Not only is this staggeringly obvious, it makes you wonder what else could possibly have been the top priority up to now?

  • rate this

    Comment number 61.

    The problem lies with Francis, he was lent on by interested parties not to apportion any blame for anything that happened. With that template established all subsequent reviews will be equally toothless and the 'same old same old' will trundle along untroubled by anything so radical as a change anywhere in the management tree. They are so well paid as to be legally untouchable.

  • rate this

    Comment number 60.


    Love the name

    Nail on head.

    The French model is successful and should be copied.
    I fear the forces of vested interests with dogmatic view of reality will fight tough and nail to keep their fantasy alive, which will result in the beast of the NHS lumbering on for many more years in its present format
    Many more reviews until reality is faced by the left

  • rate this

    Comment number 59.


    @30. Green Ears

    @Nasara, How many haven't? What are you trying to say about people who work in the NHS? Its the 2nd time you posted the same comment on this thread. No doubt will be removed again.


    Actually, it's my 3rd post! All were removed! My point is really against the BBC and its inconsistency!

    The NHS is a financial black hole, remember the PFI payments anyone??


  • rate this

    Comment number 58.

    NHS wasn't broke until HMG fixed it to fail.
    Managers in Public Services if found to be incompetent should be sacked as a wake up call to others. Same criteria should be used against incompetent MP's and those caught out fiddling expenses. In each case, no golden handshakes and where corruption is found, pensions should be voided and, in addition, banned from any public office at all levels.

  • rate this

    Comment number 57.

    The NHS was “designed” on a pseudo-Stalinist model by the Webbs and other left leaning “thinkers” – nobody with medical experience was consulted. The model does not work. It never did, and never can. We should look at (and I hate to say this) the French model. Their health service actually seems to work, and is affordable. We need action not reviews.

  • rate this

    Comment number 56.

    @ 52 NHS is bigger & better than it was 10/20/30/40 years ago, it has thousands more nurses/doctors & costs £billions more

    It might be bigger and give more services than before but in order to deliver those services you need the front line staff. Some hospitals have failed to get basic care needs right. Better care for the elderly in the community would be a good start and support for carers.

  • rate this

    Comment number 55.

    "How many reviews does the NHS need?"

    As many as it takes until those with the privatisation agenda get the result they want.

    That's what this is all about - destabilise the NHS by dragging it through the mud, under-fund it, demoralise staff so they leave and eventually you end up with a service that doesn't work and those with the agenda can say "look it's not working lets privatise it".

  • rate this

    Comment number 54.

    Cut through the carp.
    The NHS has to pull its finger out and reform, and reform quickly.
    The Black Hole of money NHS has now to understand and adapt to the new fiscal and demographic reality in our country
    This will require vested interests with dogmatic views to enter the real world (ie unions and consultants, etc)
    This will involve the private sector to a greater degree.
    Reform or be replaced

  • rate this

    Comment number 53.

    There is one huge headache with reviews - if they don't come up with the answers someone wants, they condemn the review, even if it is an accurate piece of work.

    So, someone decides that hospital A is horrendous. You conduct a review which shows that overall the hospital is actually quite good.

    Must be a whitewash!!

    Never occurs to the critic that it might be THEM that is wrong.

  • rate this

    Comment number 52.

    Judging by the comments on this, if majority of commentors got together then with a bit of a struggle may achieve 1 or 2 brain cells between the lot of them.

    NHS is bigger & better than it was 10/20/30/40 years ago, it has thousands more nurses/doctors & costs £billions more

    If you cannot see & understand that then please apply for a guide dog

  • rate this

    Comment number 51.

    The Government will keep having reviews, as long as the reviews keep saying what the Government wants - namely that the NHS requires "reform". No review tells the truth: that the NHS is an underfunded national asset greatly valued by all that use it, but one that is suffering from constant tinkering and undermining by pointless ideologues in a seemingly never ending series of clueless Governments.


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