Berwick review into patient safety

A promise to learn – a commitment to act: improving the safety of patients in England

Recommendations to improve patient safety in the NHS in England.  PDF, 359KB, 46 pages

We are recommending four guiding principles, among others, to help the English NHS get better faster, and I urge you to think about these and ask how you can help incorporate them into your own daily work.

  • Place the quality and safety of patient care above all other aims for the NHS. (This, by the way, is your safest and best route to lower cost.)
  • Engage, empower, and hear patients and carers throughout the entire system, and at all times
  • Foster wholeheartedly the growth and development of all staff, especially with regard to their ability and opportunity to improve the processes within which they work.
  • Insist upon, and model in your own work, thorough and unequivocal transparency, in the service of accountability, trust, and the growth of knowledge.

Don Berwick’s letter to the people of England    PDF, 40.2KB, 2 pages

Care of the dying patient in the community

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4085 (Published 3 July 2013)
Cite this as: BMJ 2013;347:f4085
 CME
General practice / family medicine
End of life decisions (ethics)
End of life decisions (geriatric medicine)
Extract from BMJ:The consensus from international studies of patient preferences is that, given adequate support, most people would prefer to die at home. However, more than half of all deaths in the United Kingdom occur in hospital, with only 18% of people dying in their own home. Suggested reasons for this include a lack of anticipatory care planning, poor coordination between healthcare agencies, and insufficient community resources. National and local policies now focus on facilitating home deaths, and recently there has been a small increase in the proportion and absolute number of people dying at home.

The demographics of deaths across Europe are changing with the ageing population, with deaths from dementia, cancer, and chronic diseases becoming more common.  Caring for such patients in hospital will probably become unsustainable in terms of capacity, cost, and patient satisfaction. The focus of end of life care is therefore shifting to the community—to homes and care homes—where the role of the general practitioner, with support from the community palliative care team, is key. The onus is on all health and social care professionals to work collaboratively across settings to enable patients to receive high quality end of life care in the place of their choice.

Anderson S.G., Roberts H., Malipatil N., Dunn G., Heald A.H: Diabetic Medicine

A higher index of multiple socioeconomic deprivation predisposes to development of painful peripheral neuropathy in Type 1 diabetes.

Anderson S.G., Roberts H., Malipatil N., Dunn G., Heald A.H.

Diabetic Medicine. Conference: Diabetes UK Professional Conference 2013 Manchester United Kingdom. Conference Start: 20130313 Conference End: 20130315. Conference Publication: (var.pagings). 30  (pp 70), 2013. Date of Publication: March 2013.

DOI http://dx.doi.org/10.1111/dme.12091

Maintaining High Professional Standards Consultation

Extract from NHS Employers quest

This short survey aims to gather views on the disciplinary framework for doctors and dentists employed by the NHS. The changes to the structure of the NHS and the introduction of medical revalidation have influenced the way in which the framework operates. Comments are being welcomed until 6th September 2013.

GPs list of reporting requirements from NHS England

Extract from PULSE

GP practices are being asked to report huge reams of data to NHS England so that their performance can be monitored and any ‘unwarranted variation’ can be investigated, it has emerged.

Practices are being asked to log onto an NHS England website to complete details on their surgery’s practice staff, suitability, premises and equipment, access to and availability of practice services, information about the practice and its procedures and its governance.

The ‘assurance management’ website, www.primarycare.nhs.uk, replaces the annual reports that were historically collected by PCTs, will allow for NHS England to spot any outliers and hold GPs to account in a ‘robust and fair’ way.