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Could future developments in nursing prevent another Mid Staffs?

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As part of its findings on Mid Staffordshire NHS Foundation Trust, the Healthcare Commission included the wider health service in its recommendations.

It said the experiences of patients on general wards in other trusts it has investigated have been consistently poor. It called for ‘urgent action to improve the quality of nursing care in these areas’.

Those with influence in the profession suggest the NHS Next Stage Review and the Prime Minister’s Commission on the Future of Nursing and Midwifery could leave nurses well-positioned to ensure there is no recurrence of Mid Staffordshire.

Howard Catton, head of policy development and implementation at the RCN, said the disastrous situation at Mid Staffordshire was a stark example of what happened when quality was not put at the centre of health care.

He said this must be addressed through the quality and metrics system – first outlined in the next stage review and due to be overseen by the newly-formed NHS National Quality Board (NQB).

‘There is a growing international evidence base that links staffing levels not only to quality of care but also to patient safety and mortality rates,’ he said, adding that the potential power of metrics to highlight both staffing levels and skillmix can be exploited to ensure that senior management address this.

Professor Jim Buchan, a nursing academic at Queen Margaret University, Edinburgh, who is a member of the PM’s new nursing and midwifery commission, added: ‘Events like Mid Staffordshire serve to reinforce how critical having the correct staff are to delivering quality care.’

Professor Hilary Scholefield (pictured), chief nurse at Sheffield Teaching Hospitals NHS Foundation Trust, will represent the nursing service on the NQB, which will hold its first meeting at the end of this month.

She agreed that quality metrics would give nurses more power to improve the quality of services. ‘Metrics are a very effective way of nurses raising their concerns because you can’t hide the results,’ she said. ‘If as a chief nurse you set up any system like that you have to have due regard to the results.’

She said the NQB had been asked by health secretary Alan Johnson to look at systems and processes that might have failed at Mid Staffordshire and to consider how quality can be safeguarded across the NHS.

Gail Adams, Unison’s head of nursing and also a member of the PM’s commission, added that the NMC Code of Conduct should be used as a tool to help nurses raise concerns about staffing levels, equipment failure, or standards of care.

Mid Staffordshire was accused by the Healthcare Commission of using service change as an excuse for cutting staff, and Ms Adams warned that NHS trusts must not use skillmix reviews as a method of saving money. She insisted that they should work with unions to ensure that such reviews had widespread support among nurses and other healthcare staff.

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