27.01.15
NI health review calls for expert panel to redesign services
An international panel of experts should be called in to redesign health and social care services in Northern Ireland, a review of the country’s health service has recommended.
The review, led by former England chief medical officer Sir Liam Donaldson, looked at how effectively the Northern Ireland health department and health trusts had been performing, and also looked at the care of patients and management of staff.
It found that the health system “is likely to be no more or less safe than any other part of the United Kingdom, or indeed any comparable country globally”.
However, the report did concede that things could be done better and made a total of 10 recommendations, some focusing on specialist areas of quality and safety improvement, such as maximising learning from incident reporting, while other recommendations are broader and focus on the wider health system.
Northern Ireland health minister Jim Wells presented the report to the Assembly. He said: “The report is far reaching in its implications and I agree with the main conclusions Sir Liam has made, however I will need to take more time, as should others, to consider the specifics of some of the associated recommendations.
“Despite this, there are a number of recommendations which can and should be progressed and I am determined that this should happen as quickly as possible where they point us towards opportunities for improving the quality and safety of our services.”
The minister went on to outline how a number of the recommendations will be implemented.
“I have already asked my Permanent Secretary to look at the administrative structures within the health and social care system and those supporting it,” he said. “The purpose of this is to ensure that the structures in place to support the delivery of health and social care are working – both individually and collectively – as efficiently and effectively as possible. This work will feed into future planning cycles, including 2015-16.
“Both I and my predecessor have highlighted issues in relation to commissioning and this is reflected in Sir Liam’s report. My officials have been asked to undertake a review of the existing commissioning arrangements to ensure they are effective.”
The review said that for a population of 1.8 million, there are too many hospitals in Northern Ireland which do not allow for the public to receive the best in health care. Sir Liam acknowledged that proposals to close hospitals tend to be met with public outrage but added “this would be turned on its head if it were properly explained that people were trading a degree of geographical inconvenience against life and death”.
Therefore, Sir Liam has recommended that all political parties, and the public, accept in advance the recommendations of an impartial international panel of experts who should be commissioned to reconfigure health services.
The report goes on to criticise the implementation of the Transforming Your Care programme, which Sir Liam said required a "rocket buster" to implement it.
He also suggested that the Patient and Client Council needed to become independent from the health department in order to best represent the interests of patients.
On the issue of regulation, he recommended that the regulating body the RQIA, could be outsourced so it can make more of an impact. It also said the body should review the current policy on whistleblowing.
In his statement to the Assembly, Wells said that a statutory duty of candour will be introduced in Northern Ireland.
“There should be no ambiguity in respect of my expectation regarding the crucial elements of patient safety which are openness and transparency,” he said. “I recognise that, despite the best efforts of doctors, nurses, social workers, other staff and managers, mistakes can and do happen. Patients, service users and the public have a right to expect that when they do, they will be communicated with in an honest and respectful manner and that every effort will be made to correct errors or omissions and to learn from them to prevent a reoccurrence.
“I have therefore asked my officials to begin the process to create a statutory duty of candour in Northern Ireland so that, supported by professional codes of conduct which already exist we might bring about the strongest possible form of openness and transparency in Northern Ireland.”
Wells said it is a time for those who are committed to the delivery of high-quality health and social care services to engage in open, honest, intelligent debate.
He added: “The message from Sir Liam is clear, we now need a mature debate and we need to strive for political consensus to empower us to collectively make the right choice. Whilst we are moving ahead with some of the recommendations, I am also asking for written comments on recommendations to be submitted to the Department by end April 2015. This gives an opportunity for stakeholders to reflect and engage with each other, with political representatives, and with the Department.
“I have specifically asked that the six health trusts work with each other, with their staff and other stakeholders to develop a combined response to the report and its recommendations. Their response should in particular reflect the views of front line staff and should also focus on their ideas for improving collaborative working, ending silos, increasing standardisation and promoting innovation. Front line staff must be empowered. In short, they hold the key to delivering on the change which is needed.”
(Image: Library picture of Sir Liam Donaldson. Source: AP Photo/KEYSTONE/Martial Trezzin)
Tell us what you think – have your say below or email [email protected]