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NHS England pledges further action to protect patient safety following Berwick Report publication

NHS England today welcomes the Berwick Report into NHS patient safety, and pledges further action to help make the NHS the safest healthcare system in the world.

Professor Don Berwick, renowned international expert in patient safety, was asked by the Prime Minister to carry out the review following the publication of the Francis Report into the breakdown of care at Mid Staffordshire Hospitals which has now been presented to NHS England and the Department of Health.

His report makes recommendations for the NHS, its regulators and the government in building a robust nationwide system for patient safety rooted in a culture of transparency, openness and continual learning with patients firmly at its heart.

Jane Cummings, Chief Nursing Officer, is NHS England’s national director responsible for patient safety. She said:

“Don Berwick’s report is landing at exactly the right time for the NHS. He has highlighted many of the key areas that the NHS is actively addressing to give our patients quality care every time and support our staff to work with the right conditions for success.

“NHS England welcomes the focus on growing a culture which puts patients first, engages and empowers patients and carers, supports transparency and learning and takes responsibility for poor care. This is all underpinned by having the right staff with the rights skills and knowledge. We are already tackling this through the actions set out in Compassion in Practice and by working with NICE and other key partners such as Health Education England.

“This report demonstrates the passion for patient safety that so many in the NHS have and will be a touchstone for patient safety in the NHS for the next decade or more. NHS England accepts the challenges set in this report and will lead the way in responding.”

In response to the recommendations in the report, NHS England will work with its national partners across the health and social care system to assess and implement the recommendations. We will examine the recommendations in detail to establish how they can be implemented across the NHS, in the context of existing projects and other key recent reports about the safety and quality of patient care.

NHS England’s Director of Patient Safety, Dr Mike Durkin, said: “As part of the restructure of the NHS system, patient safety is now firmly embedded where it should be, at the heart of our health service. At NHS England, we are working with leading clinicians right across the NHS to assess and understand what can go wrong in healthcare using analysis of hard and soft data and then develop new ways of working to make their patients safer.

“More and more NHS clinicians are reporting incidents and “near-misses”, however minor they may at first seem, to our national systems. Reporting these incidents is not about punishment – it’s about making sure all parts of the NHS learn from one another, gaining a full understanding of what can go wrong and how it can be prevented in future. As Don Berwick makes clear in his report, an open, supportive culture where it is understood that humans make genuine mistakes, is key to this.

“Don Berwick’s report contains a number of actions that everyone in the NHS can implement immediately – building on the improvements we have already started to make to improve how we listen to patients and working even harder to seek out and address risks to patient safety. Other elements which cut across the NHS and its regulatory system will need to be considered in detail, and I look forward to working with colleagues throughout the healthcare system to fully consider them as a top priority.

“We are very grateful for the time and effort that Don and the whole Advisory Group have put into this report. Their integrity and passion for patient safety have resulted in a landmark set of findings.”

The report also includes three letters written by Professor Berwick to senior government officials and senior executives in the NHS; clinicians, managers and all NHS staff, and the people of England (documents available via our archived website).