Final Report > Recommendations > Purpose of the Recommendations

Purpose of the Recommendations

• To meet our Terms of Reference.
• To advance the central notion of a patient-centred healthcare service committed to continuous improvement. We adopt as our starting point that the NHS exists to serve patients.
• To promote a new culture within the NHS: a three-way partnership of respect, honesty and openness between:
• NHS and public;
• professionals and patients; and
• professionals and professionals.
• To give effect to the following:
• The patient must be at the centre of everything which the NHS does.
• The commitment and the dedication of staff in the NHS must be valued and acknowledged: those caring for patients must themselves be supported and cared for.
• There must be openness and transparency in everything which the NHS does.
• The impact of the way in which services are organised on the quality of care which patients receive must be recognised: the quality of care depends on systems and on facilities, as well as on individual healthcare professionals.
• All those involved in healthcare - doctors, nurses, other healthcare professionals, and managers - are collectively healthcare professionals: each group must recognise and acknowledge the contribution of others in the service of patients.
• The safety of patients must be the foundation of the NHS's commitment to the quality of its services.
• Sentinel events, that is, errors, other adverse events, and near misses, which occur during the care of patients, must be seen as opportunities to learn, not just as reasons to blame.
• There must be clear and understood systems of responsibility and accountability: a culture of blame is no substitute for such systems.
• The quality of healthcare must be guided by agreed standards, compliance with which is regularly monitored.
• The role of central government in relation to the NHS should be:

a) to act as its headquarters in terms of management; and

b) to create independent mechanisms for regulating the quality of healthcare and the competence of healthcare professionals.

• The various independent bodies must themselves be co-ordinated so as to avoid the fragmentation of responsibility which arose in the past. Existing bodies, suitably shaped, must be used. We recommend the creation of only one new body.