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Berwick pays tribute to NHS staff in letter

Professor Don Berwick, the US patient safety expert, has noted the “intense spotlight” that NHS staff work under in a letter accompanying his report for the government.

Professor Berwick’s report, published earlier today, sets out a range of recommendations such as adopting improved transparency, a “culture of learning” and criminal offences for wilful neglect or mistreatment – but stopped short of calling for mandatory minimum staffing levels.

Accompanying the report, he published a “letter to the clinicians, managers, and all staff of the NHS” – separate letters were also addressed to ministers and senior NHS leaders, and the general public.

In the letter to staff, Professor Berwick paid tribute to the NHS and its work, while noting that it got “rough sometimes” for the service because it was in the public and media eye.

“For the nearly three decades that I have been able to observe and work with the NHS, nothing has impressed me more than you – the workforce of 1.3 million people who are trying to make real a vision of a vital, universal healthcare system, accessible to all, and free at the point of service,” he wrote.

“Because you work in a publicly led and publicly funded system of care, you operate under a spotlight more intense than most professional communities ever do,” he added. “Every experienced clinician knows what it feels like to be involved in an error in care, despite one’s very best efforts.

“The abstract concept of a ‘system’ that fails has concrete meaning in the life of every doctor, nurse, or therapist who couldn’t find a crucial test result, became exhausted when staffing was inadequate to meet patients’ needs, or watched a patient get an infection in a hospital,” Professor Berwick wrote.

“When things go especially badly, as happened, for example, in Mid Staffordshire, and public and private sentiment heats up, it can feel especially rough,” he added.

Professor Berwick said his report was his expert group’s “best effort” at identifying changes that could help the NHS in England become “the effective, safe, and patient-centered system that you who work in the service want it to be”.

He added that “real, sustainable, active improvement” depended more on learning and growth than on rules and regulations.

“The balance we are suggesting that the NHS seek to strike – between the hard guardrails that keep things in proper order and the culture of continual learning that helps everyone to grow,” he said.

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