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 210.

    The problem of "Free at the point of need' is 'need' being a subjective term based on the 'patient'. The NHS should:
    1 Charge visitors to the UK for treatment
    2 Charge for narcissistic cosmetic surgery
    3 Have pharmacists in hospitals to decide if people need A&E and sell basic items e.g. aspirins, plasters

  • rate this

    Comment number 209.

    #206 Gary the NHS does NOT need more business managers or any more jobsworths administrators - it needs DOCTORS and NURSES who really care about their patients and their profession

  • rate this

    Comment number 208.

    Nothing to do with privatisation. All the problems started before privatisation - the viruses, the neglect, the "its not my job culture", the "its everyones responsibility therefore its not my responsibility - like cleanliness". This is about doing your job as a team and with individual responsibilities learning and improving.
    Annual reports should be done by independent external bodies not peers.

  • rate this

    Comment number 207.

    CAN a 'good society' have a 'bad health service'? No

    Can a 'bad society' have a 'good health service'? We tried

    What next?

  • rate this

    Comment number 206.

    The NHS is a constant state of review to make up for its woeful process driven and indecisive management. The NHS needs to employ more people with business acumen and customer service experience with analytical minds, innovative ideas and clear and robust decision making. The NHS needs to move away from stipulating previous NHS experience as an essential in 90% of its job adverts.

  • rate this

    Comment number 205.

    "Scrap NI payments and make people pay into a Health Insurance"

    Health insurance run by companies owned by DC's fat-cat buddies?

    No thanks.

  • rate this

    Comment number 204.

    Mr Cameron (and cronies) ... we KNOW what you are doing.

    We got privatised dental treatment - we didn't want it.

    We are being softened up for the same to happen to GPs and A&E and ambulance service.

    It is going to COST you votes.

  • rate this

    Comment number 203.

    Lets scrap the NHS.

    There you go a review that is needed, but the Politicians wont go anywhere near it all parties. The NHS is a bottom less pit.

    Scrap NI payments and make people pay into a Health Insurance

  • rate this

    Comment number 202.

    Perhaps we need someone like Godfrey Bloom as PM - at least he seems to say what he thinks rather than what people want him to say, unlike most of our politicians who want a politically correct review of as many subjects as is possible.

  • rate this

    Comment number 201.

    I may be being a little paranoid here, but are we actually certain that the NHS is in 'meltdown' or 'crisis' ? It seems that every week there is new horror story about the NHS on the BBC or Sky News, and the thought occurs, are we just being persuaded that this is no longer the way to go, and that private companies can offer a better, safer service ? Like i said, could just be me being paranoid.

  • rate this

    Comment number 200.

    Lots of comments here about privatising the NHS. Privatisation may cost the consumer a bit more but it certainly clears out the dead wood. Lets privatise the Government and the BBC before the NHS

  • rate this

    Comment number 199.

    This Dog of an incompetent govt is addicted to spending our money like drunks on a Friday night, so expect more reviews. They have wasted money on West Coast Fiasco (£40m) Police Comm Elections (£100m) Boundary Changes (£12m), NHS £3bn.
    Increased DEBT to £1.4tn in only 39 months, so expect more fiascoes and unnecessary reviews while their extreme right wing policies being covered up by Media

  • rate this

    Comment number 198.

    Review by the private sectors in all aspects of local care, And registration for all social workers.

    They are people unfit to contribute anything, sitting on review boards that are getting paid 10s of thousands over a year for 10 hours work a month. They are front line nhs staff cuts being made to pay for them, it has to end.

    They are a lot of people in the public sector not fit for the job

  • rate this

    Comment number 197.

    Although I criticise our political system the British public could do more to cut costs to the NHS and many other services. Take obesity. People can do more to minimize the cost to the NHS but many are either convinced it is a gene problem or are too lazy to do it themselves. The only jean problem they have is they no longer fit.

  • rate this

    Comment number 196.

    The NHS can have countless reviews but no real change will occur as like the remainder of the public sector it is badly managed and any change is resisted by unions fearful of loss of power

    That coupled with interfering politicians, whether labour or tory, means that resources are wasted and patient care compromised

  • rate this

    Comment number 195.

    The problems can be seen and can be fixed
    But finding a suitable ‘political’ solution seems insurmountable
    All parties are afraid of the real issues because “the NHS is safe in their hands”
    We are told it’s the envy of the world and we meddle at our peril, yet we know it’s broken.
    It seems we can’t criticise without undermining the staff or damaging political ideology.

  • rate this

    Comment number 194.

    Year in year out, the ready reaction of 'left' and 'right', to blame all on the personnel, and/or context, of either the 'private sector' or the public!

    So well 'educated', we seem UNABLE to hold in our minds the disasters of 'our own side', NEVER to appreciate that IF there is hope it is in a THIRD context

    Inducted to deride as 'fascist' or 'communist' or 'looney' the obvious: Equal Partnership

  • rate this

    Comment number 193.

    Reviews are like quangos, vastly overpaid jobs for mates of the political class. Their reports at best state some obvious things most could have told you with no time or cost. Reports shelved, money gained.

  • rate this

    Comment number 192.

    How about a review into the management of the NHS - oh we don't need one, the fact poor elderly care, decaying A&E, varying death rates, cost overruns, inept PPI schemes etc etc tells us that the NHS is being poorly managed. The various Govs who just ignore this, pay more for inept managers, refuse to face difficult choices and use it as a political football are destroying a great institution.

  • rate this

    Comment number 191.

    185: Ah yes of course. Hard to argue against that point as I haven't seen any data reflecting nationality in regards to accessing A&Es etc. It wouldn't be available for a lot of A&Es as it's not mandated so a sample would be needed. Probably a worse problem in London so would depend where the service was based. Hard to pin a price on.


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