In this report the Professional Standards Authority for Health and Social Care sets out its view on the biggest challenges affecting the quality and safety of health and social care. It puts forward a number of recommendations to ensure safer care for all, with its main recommendation being that an independent Health and Social Care Safety Commissioner should be appointed for each UK country to identify current, emerging and potential risks across the whole health and social care system, and bring about the necessary action across organisations.
The report considers four main themes:
1) Tackling inequalities
The report sets out that there are persistent, major inequalities in access to and experience of healthcare services. To help tackle this, it states that the system as a whole needs to improve the way it collects data about the protected characteristics of complainants, so that we can see start to identify any differences in how care is delivered, and how complaints are handled.
2) Regulating for new risks
It highlights that the way health and care are funded and delivered is changing. There is an increase in ‘high street’ provision and the use of technology; disrupting factors, such as commercial and financial interests, can interfere with professional judgement, and put patients at risk. Governments and regulators must be ahead of the curve as delivery changes, to identify emerging risks and protect the public. It suggests that they should use the current reforms to healthcare professional regulators to ensure they have the agility to address new challenges.
3) Facing up to the workforce crisis
The report states that the UK is facing a serious workforce shortage in health and social care, which must be addressed to avoid services suffering and patients and service users being at risk from harm. It calls for the four UK governments should work together to develop a coherent strategy for the regulation of professionals, to support delivery of the national workforce strategies.
4) Accountability, fear and public safety
It notes that individual accountability plays a key role in keeping people safe in health and care. The Professional Standards Authority states that it has concerns about the safe spaces approach in England (where the law may prevent the disclosure of information that staff provide to safety investigations). They state that UK government should ensure that this approach does not undermine existing public protection mechanisms or reduce transparency when things have gone wrong.
Structural flaws in the safety framework
The report also identifies a sector-wide problem of structural flaws in the safety framework, stating that the patient and service user safety landscape is fragmented and complex. Concerns raised often fall between organisations, or are left unaddressed due to jurisdiction issues or insufficient powers. Large-scale failures of care still occur frequently, and inquiries and reviews highlight similar themes and issues, with the system seemingly unable to prevent their recurrence. Each body looks at the problems principally through the lens of its own remit, often prejudging the nature of the solutions as a result. We need a new framework focused on safety that spans organisational and sectoral boundaries.
In response to this, its core recommendation is the appointment of an independent Health and Social Care Safety Commissioner (or equivalent) for each UK country to identify current, emerging, and potential risks across the whole health and social care system, and bring about the necessary action across organisations.