Donaldson Report Published

Wells – Report presents opportunity to transform our Health Service to a world leader

Health Minister Jim Wells has published Sir Liam Donaldson’s report which examines the governance arrangements for ensuring the quality of health and social care provision in Northern Ireland.

Speaking in the Assembly today the Minister said: “This report states that our 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”. Although Sir Liam also acknowledges that we can do better, that statement should be of some comfort and reassurance to those in our community who rely on our health service.”

The report makes ten 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 our health system.

The Minister 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. He said: “I have already asked my Permanent Secretary to look at the administrative structures within the health and social care system and those supporting it. 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 Minister announced that a statutory duty of candour will be introduced in Northern Ireland. He said: “There should be no ambiguity in respect of my expectation regarding the crucial elements of patient safety which are openness and transparency. 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.”

Further actions the Minister announced today included:

• a Never Events list to be developed for Northern Ireland, with urgent consideration of the applicability of the list for England as an interim measure

• concluding the work to introduce a regional morbidity and mortality review system as well as the development of proposals, in conjunction with DFP and DOJ, for a new independent system to review deaths in Northern Ireland complementing the role of and working with the Coroner

• instructing the HSCB and PHA to prioritise changes to the Serious Adverse Incident (SAI) system

• seeking to speed up the roll out of unannounced inspections of acute hospitals

• new policy proposals to review the 2003 Quality, Improvement and Regulation Order with a view to introducing a stronger system of regulation of acute health care providers

• proposals to the Executive for changes to the existing system of regulation of non-acute services with the aim of issuing these proposals for consultation by June 2015.

• review the operation of whistle blowing in health and social care bodies with recommendations on how to improve its effectiveness

• apply the best available worldwide evidence on measuring patient/client experience and design a framework to strengthen the voice of patients at every level

On Transforming Your Care (TYC) the Minister said: “I am determined, even though we are working within a constrained financial context, that we must redouble our efforts to speed the implementation of TYC. The best change comes from the ground up and I want to facilitate those at the coal face to play a fuller role in delivering the transformation. We need to enthuse front line staff and empower them.”

The Minister 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.”

Concluding the Minister said: “In summary, Sir Liam has concluded that we have a real opportunity to transform our Health Service to be a world leader. That, is an ambition I cherish.”

Notes to editors:

1. View the full report, Minister’s full statement to the Northern Ireland Assembly and how to reply to the department about the report at
2. The Commissioning Review will:
a. Undertake an assessment of how the commissioning process facilitates the delivery of high quality and efficient health and social care services in Northern Ireland, with particular reference to
• Assessing the health and social wellbeing needs of the population of Northern Ireland.
• Strategic planning to prioritise needs within available resources, including the use of financial and other levers, to reshape services to meet future needs.
• Engaging patients, users, carers / families and other key stakeholders at a local level in the commissioning of health and social care services.
• Securing, procuring, incentivising and agreeing high quality, value for money service provision to meet the assessed and prioritised needs of the population.
• Ensuring the delivery and outcomes from services commissioned.
• Evaluating impact of health and social care services and feeding back into the commissioning process in terms of how needs have changed.
b. Bring forward recommended options to improve the effectiveness of the delivery of health and social care services in Northern Ireland.
c. It is expected that the review will report in the summer of 2015.
3. Media enquiries about this press release to DHSSPS Press Office on 028 9052 0575, or out of office hours contact to Duty Press Officer via pager number 07699 715 440 and your call will be returned.

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