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Berwick report: Unions welcome emphasis on 'culture of learning' for staff

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Unions representing clinicians have largely welcomed the recommendations made in the Berwick report on NHS patient safety, despite it stopping short of calling for mandatory staffing levels.

The report by patient safety expert Professor Don Berwick was published earlier today. It set out a range of recommendations such as adopting improved transparency, a “culture of learning” and criminal offences for wilful neglect or mistreatment.

It also said healthcare organisations should ensure staff are “present in appropriate numbers to provide safe care at all times and are well-supported”, but did not recommend the introduction of minimum staffing levels or ratios.

The Royal College of Nursing said it welcomed the report’s “positive, and practical, recommendations” and that it could represent a “great leap forward” for the NHS.

RCN chief executive and general secretary Peter Carter said: “This is the latest in a series of thorough reports by well-respected experts which is urging a focus on having the right number of registered nurses and support staff to care for patients.”

He added: “We’re particularly pleased to see the focus on creating and supporting a culture of learning, to motivate staff, and making sure leaders are visible and approachable and understand the realities of patient care.

“Ward sisters have a vital role to play in that visibility; giving support, guidance and supervision to their teams to ensure an open culture and a high performing ward.”

Unison said the Berwick report was a “rallying cry” to the government to invest in the NHS.

Unison head of nursing Gail Adams said: “We are pleased that the review recognises the link between patient safety and having enough staff, with the right skills on the wards.”

But she noted that Unison would continue its call for safe nurse to patient ratios to be introduced.

Ms Adams added: “The review is right to emphasise the importance of life-long learning as key to providing safe and professional care. 

“For too long many staff have been ignored when it comes to getting access to continuous training to the detriment of the whole service.”

The Royal College of Physicians said in a statement Professor Berwick was “right to identify cultural change as the most important factor in reducing harm to patients”.

But it added: “An emphasis on appropriate staffing levels would also help the NHS cope with the increasing strain it is under due to the inexorable rise in emergency admissions, the increasing proportion of inpatients with dementia and comorbidities, poor continuity of care, out-of-hours care breakdown and a looming medical workforce crisis.”

British Medical Association chair Dr Mark Porter echoed the RCP’s views on culture and staffing.

“We firmly believe that there must be a change of culture across the NHS and we support Professor Berwick’s call for patient care to be made paramount and for a culture of support, not blame, to empower staff,” he said.

“We need to examine further the proposals for new criminal offences and work with the Department of Health to see if these add anything further to the existing sanctions.”

But he added: “The government must also ensure that their programme of cuts across the NHS does not lead to any further reductions in the number of NHS staff whose role it is to provide care.”

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