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Nursing code of conduct judged to be 'fit for purpose'

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The professional codes for nurses and doctors are fit for purpose – but further work should be done to provide incentives to ensure all staff are more open, the medical director of NHS England has reported.

Sir Bruce Keogh was asked to review the codes by Jeremy Hunt after the inquiry into maternity services at University Hospitals of Morecambe Bay Foundation Trust was published earlier this year.

“I believe the codes, as far as they go, are fit for purpose”

Bruce Keogh

In a letter to the health secretary, published this morning, Sir Bruce delivered a progress report on his review, which was intended to look at whether the professional codes provided the right incentives to prevent people from covering up, instead of reporting and learning from mistakes.

He said: “I believe the codes, as far as they go, are fit for purpose; and the insertion of the professional duty of candour is a welcome sign that the professional bodies recognise the importance of the issues you have raised.

“However, there is more that could be done. Not least a message that true professionalism includes a presumption towards open, frank and considered behaviour,” he said.

He added: “I would like to work with the professional regulators to see what further incentives we could agree to ensure all NHS staff – whether clinical or managerial – are more open.”

Mr Hunt name-checked Sir Bruce’s review of the professional codes in a major speech on the NHS this morning.

The health secretary said: “He [Sir Bruce] says that whilst there have been some improvements, more work needs to be done on incentives so that, like the airline industry, the default option is openness and not reticence when dealing with errors.

“At its heart this is about rediscovering true professionalism in a clinical context,” he said.

In his letter, Sir Bruce said further work would be undertaken with the Professional Standards Authority in September.

He suggested he would like to agree steps that all nine of the professional regulators could take to develop a “common set of values to encourage these behaviours and promote quality improvement across the NHS”.

A set of proposals will be submitted in October that aim to focus on “how we could promote a more balanced approach to harness the power of values, behaviours and professionalism as drivers for improvement across the NHS, rather than a focus on professional regulation and failure”, he said.

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