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1 We learned from both Phases of our Inquiry that what we heard about in Bristol, in terms of attitudes and in terms of competence, broadly defined, was not unique to Bristol. Nor was it limited just to the period of our Terms of Reference. Indeed, anyone reading the recent review into the Oxford Cardiac Services  would find uncanny similarities to what we describe in Section One in the case of Bristol. Yet it referred to events between 1995 and 1999. The report into paediatric cardiac services at the Royal Brompton and Harefield Hospitals  only appeared in April 2001, yet it too has echoes of the events and circumstances of Bristol. The continued existence of shortcomings in professional competence clearly undermines the capacity properly to care for patients.
2 This chapter looks at the range of skills of healthcare professionals. We argue that, in the case of doctors and nurses, technical clinical skills are a necessary but not a sufficient qualification to practise as a healthcare professional. For the future we must expand our understanding of what constitutes professional competence. Attitudes and interpersonal skills must be recognised as having value alongside clinical skills. This has consequences for the way in which future healthcare professionals are selected and educated. In the second part of this chapter we consider the systems for ensuring that competence is acquired and then maintained throughout the professional's working life. We identify areas where these systems need to be strengthened. We give particular attention to the way in which professionals acquire new clinical skills. Some of our observations relate to particular professions but most relate to all healthcare professionals (managers, doctors, nurses and other healthcare workers).
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