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Independents' Day

Berwick report backs patients having a 'named GP' responsible for care at all times

A major report into improving patient safety in the NHS has backed the health secretary’s call for a ‘named clinician’ - likely to be a GP - to be responsible for coordinating patient care at all times.

The Government-commissioned report - led by patient safety specialist and former adviser to the US President Professor Don Berwick - concluded that a ‘specific, named and recognised clinician’ should be leading on a patient’s care at every phase of treatment.

Health secretary Jeremy Hunt has previously said he wants this ‘named clinician’ to be his GP and Professor Berwick said that would be a ‘good idea’ but may vary throughout the country.

The report - published today - said that the NHS does not always put patient safety first and presents a range of recommendations for how to correct the problem.

It recommended that the NHS places the quality of patient care, especially patient safety, ‘above all other aims’ and that health service staff ‘are not to blame’ for lapses in safety as in the vast majority of cases it is the systems and procedures they face that lead to problems.

The report also said that CCGs and NHS England should ensure there always was a named clinician, known to the patient, responsible for coordinating their care regardless of setting.

The report said: ‘NHS England, CCGs and provider organisations should ensure that a specific, named and recognised clinician, known to the patient, is responsible for the coordination of care for every patient at every phased of treatment regardless of setting.’

The advisory group was set up after the Francis Inquiry into failures of care at Mid-Staffordshire NHS Foundation Trust.

Professor Berwick said that they had discussed the idea of who should be the coordinator of a patient’s care.

He said: ‘The GP did come up as GPs are very crucial across the NHS and would be a very good answer.

‘We were reluctant to specify a particular person though, or role, because basically it is contextual and in some parts of the country it may not be a physician who is the best coordinator, but there should be somebody. Every patient should know at every single point who has the responsibility for coordinating their care.’

Amid other recommendations, the report said there should be new criminal offences created for NHS staff for ‘wilful’ harm or neglect of patients and recommended a full-scale review of the NHS regulatory system by 2017. But it did not back the suggestion - also in the Francis report - for a ‘duty of candour’ for individual NHS staff.

The Government is due to respond to the report together with its full response to the Francis report in the autumn.

Mr Hunt said the report was a ‘call to action’ for the Government to make the NHS ‘the safest healthcare system in the world’.

BMA chair Dr Mark Porter said he supported Professor Berwick’s call for patient care to be made paramount.

He said: ‘Doctors care deeply about patient care and we now look forward to hearing more from the Government on how Professor Berwick’s review will be implemented.

‘Doctors play a vital leadership role across the NHS in driving forward change and we hope that the Government comes to recognise this and gives doctors a real voice in helping to meet the challenges the NHS faces.’

RCGP chair Dr Clare Gerada said the report had the potential to be a ‘game changer for the NHS’.

She said: ‘We urge Ministers to take heed and act on its recommendations. The Government now needs to take responsibility for fostering a climate within the NHS that supports staff and allows them to continuously improve. By doing this, we will put safe patient care back at the core of everything that the NHS does and restore public trust and confidence.’


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  • Jeremy Hunt - online

Readers' comments (15)

  • Then please let me treat patients not QoF templates.

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  • I am not quite certain what power the named clinician has. If the named clinician says the operation needs to be done this week will it happen? If the named clinician be contacted to confirm he/ she is ready for discharge before he is sent home? Can the named clinician bring forward the outpatient appointment if he/she needs to be seen earlier?

    If yes thats great, if no then the named person needs to be someone who can control and influence these decisions. Maybe someone elected to government and appointed to the cabinet with a responsibility for health can influence these decisions and so should be the named responsible person for everyone. Or maybe, just maybe people should take responsibility for themselves.

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  • The devil is in the detail.Let's wait and see

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  • Indeed the devil is......and we all know what paving stones are laid on the road to Hades.....

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  • Today, I had a patient tell me it is my fault he got so drunk he let other people into his house and everything got stolen. Apparently this is the duty of care he feels I have towards him as his GP and I am responsible for straightening out his life.

    This is the kind of attitude we will expect more of should be implemented. No one takes responsibility except us. And yes, your job as well as your criminal record will be at stake.

    I really should quit this job.

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  • This will be like music to the DOH.Yet another report suggesting GP's should be responsible for some patients 24/7. I wonder what the conlusions of the current NHS England consultation will be! Answers on a postage stamp please.

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  • Madness. The Govt. would spend 13 million on a Francis enquiry rather than 1 million on adequate staffing levels that would provide safe and proper care; then blame the completely overwhelmed staff for the failings.
    Proper funding, proper staffing is what is needed. Almost every single person in the NHS works harder and more than they are paid for. More checks, more and more paper work.
    Time for us doctors to think seriously about following dentists out of the NHS, before every single one is either depressed, burnt out or left prematurely.

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  • Re-inventing the wheel.
    in my youth if a GP felt they could not deal with the care of a patient they asked the hospital to take over the responsibility of care. The hospital did their thing and discharged back to the GP and their team. Once the sugery was closed the responsibility passed to the on call doctor, later to be the co-operative of on call doctors. All communicated with each other and took responsibility when it was their turn.
    There is absolutely no need for it to be different.

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  • This must be an oppurtunity. Multiple attacks on primary care by politicians recently . We need to be micromanaged in almost all of our professional activities - according to the government . Now we are to be a named person responsible 24/7/365. Somewhere in the report there must have been a costing for this. It would also now require TRAINING, AUDIT, RERVALIDATION,
    Not sure how much it would cosrt in the USA to start such a program. Even on less than minimum wage at £5/hr for this we are all goint to get an extra £55,000 per year. Party time !!!!

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  • Another ten thousand G.P.s wanted . Any takers?

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