Government publishes 'blueprint for trustworthy' NHS

The NHS in England needs to undergo a "profound transformation" to create an open, honest and learning culture, the health secretary says.

Jeremy Hunt spelt out the challenge as he unveiled a series of measures in response to the public inquiry into the Stafford Hospital scandal.

He said the NHS had the potential to become the "safest in the world".

One of the key steps included getting hospitals to publish details of whether they have enough nurses on wards.

From April, patients will be able to see the numbers on a new national safety website.

There will be no national minimum staffing standard, but it is likely to include recommended nurse-to-patient ratios for different types of ward.

Ministers also announced:

• Hospitals will have to produce quarterly reports on how they are handling complaints and clearly set out how patients can raise them.

• A legal duty of candour on organisations to be open and honest about mistakes.

• A criminal offence of wilful neglect to hold staff to account.

• A "fit and proper person's test" so managers who have failed in past will be barred from taking up posts.

• A care certificate to ensure healthcare assistants and social care workers have the right skills and training.

• Every patient should have the names of a responsible consultant and nurse listed above their bed.

Mr Hunt added: "Today's measures are a blueprint for restoring trust, reinforcing professional pride in frontline staff and above all giving confidence that they will be given the best and safest care and the way to do that is to be completely open and transparent.

"I believe we can be the safest healthcare system in the world with these changes."

Intense debate

The neglect and abuse at Stafford Hospital between 2005 and 2008, which led to the unnecessary deaths, has already been well documented.

But the £13m Francis Inquiry, published at the start of February, and this response from the government, has been aimed at tackling the wider cultural problems in the NHS.

The inquiry accused the NHS of putting corporate self-interest ahead of patients and concluded that the failings went from the top to the bottom of the system.

In total 290 recommendations were put forward and Mr Hunt said the measures announced address the overwhelming majority of them.

However, it is the move to get trusts to be open over staffing levels that is attracting the most intense debate.

It is something the Francis Inquiry said should be looked at and that the Safe Staffing Alliance, which includes organisations such as the Royal College of Nursing (RCN), and Health Select Committee have called for to be introduced.

The government has already asked the National Institute for Health and Care Excellence, the official advisory body for the health service, to look at how safe staffing should be measured.

Evidence suggests different levels of staffing are needed for different wards.

'Open and honest'

A new website - expected to be run by NHS England or the Care Quality Commission - is likely to give details on numbers of staff and whether they breach recommended levels.

It will be up and running by June and will include data on staffing levels on each ward, each day. It will be updated monthly.

It is also expected to include information on other indicators, such as death rates and complaints, although these are already publicly available.

Chief Nursing Officer Jane Cummings said there was a "very clear link" between staffing and risk.

"Patients and the public are therefore entitled to know that we have the right number of people in place to provide safe, quality care every time."

But RCN general secretary Peter Carter said the "greater transparency" will raise the issue of whether there are enough staff available.

Official figures show 6,000 nursing posts have been lost since the election - about 2% of the total.

"It is also important that trusts are able to take action if their staffing levels fall below this number," Mr Carter added.

Labour's shadow health secretary Andy Burnham said: "Too many hospitals in England do not have safe staffing levels.

"We have repeatedly warned the government about nurse numbers falling to dangerous levels. This new focus on recruitment is overdue but it shouldn't have taken this long and it won't be enough to repair the damage of three years of falling nurse numbers on David Cameron's watch."

Peter Walsh, chief executive of Action Against Medical Accidents, warned ministers were at risk of making a "disastrous" mistake if they did not extend the legal duty of candour to include all errors - at the moment the government has only said it will apply to mistakes that cause death or severe harm although it is going to consider whether to extend that to include moderate harm.

And Julie Bailey, of Cure the NHS, the campaign group which helped bring the problems at Stafford Hospital to national attention, added: "We are very disappointed and are not happy at all.

"This is going to create more bureaucracy in the NHS not improve things."