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Commitment to learn

The lessons from Mid Staffs should resonate beyond England and more widely than hospital care.

Treating patients with dignity and respect should be considered a hallmark of healthcare. Yet the catastrophic failings in care at Mid Staffordshire NHS Foundation Trust in the mid-to-late 2000s, detailed in Sir Robert Francis’s 2013 report, serve as a reminder of what can happen when financial ambitions subvert clinical priorities.

Don Berwick had the task, a year ago, of distilling Francis’s 290 recommendations into a manageable set of themes for improvements in culture of care and patient safety. Berwick’s subsequent report ‘A promise to learn — a commitment to act’, called for a systemic change within the NHS. 

The NHS must abandon blame as a tool and trust the good intentions of staff. It must recognise that transparency is essential and insist on it. Pride and joy in work, not fear, must infuse the NHS. Berwick believes the NHS should be “devoted to continual learning and improvement of patient care, top to bottom and end to end”.

These sentiments might seem trite, but the Berwick report is thorough. And its tone is markedly different from that of the Francis report, which is accented by words such as harrowing, appalling, disaster, shocked, bewildered — all aptly applied. Whereas Francis focused on failings, Berwick was seeking to move forward.

Mid Staffordshire NHS Foundation Trust is being dissolved and although it may not exist, it should remain a part of our collective consciousness.  “There’s a little bit of Mid Staffs in every trust,” said one senior pharmacist at an event related to the Francis report.

None of the UK health services can afford to dismiss the lessons from Mid Staffs as matters for England alone. Moreover, the Berwick report applies beyond the hospital ward. Care homes, community services, homecare providers, social care — even community pharmacy — should have considered the recommendations.

The Berwick report was published a year ago this week. But it was not a report for 2013. It ought to be revisited regularly by managers, board members and front-line staff as a reminder, a sense check, a commitment to learn.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066084

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