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NHS becomes first healthcare system in the world to publish numbers of avoidable deaths

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The NHS will become the first healthcare organisation in the world to publish estimates of how many patients may have died because of problems in their care.

The publication follows a promise by the health secretary after a 2016 Care Quality Commission report found that the NHS was missing opportunities to learn from patient deaths, and that too many families were not being included or listened to when an investigation happened.

The data will be published each quarter by individual trusts. 171 of the 223 trusts in England have already released or are releasing their first estimates by the end of December.

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Each trust will make its own assessment of the number of deaths due to problems in care. The data will not be comparable and will not be collated centrally. This will allow trusts to focus on learning from mistakes and sharing lessons across their organisations and their local healthcare systems.

Jeremy Hunt, The Health Secretary, said:

Every death resulting from a failing in care is an absolute tragedy, and despite the NHS being ranked as the world’s safest healthcare system for a second time, we still have a long way to go.

Too often I have heard from families saying that after mistakes happen they feel like a wall has gone up in the NHS, but publishing this data will help give grieving families the openness and answers they deserve. It marks a significant milestone in ensuring the NHS learns from every tragic case, sharing lessons across the whole system to prevent mistakes recurring and ultimately delivering safer care for all patients in the future.

The programme is likely to cover between 1,250 and 9,000 deaths, which research suggests is the number of deaths each year that may be down to problems in care – a fraction of the 19.7 million treatments and procedures carried out by the NHS in 2016 to 2017.

These deaths range from rare but high-profile failings in care, to those which involve terminally ill patients who die earlier than expected. These deaths may make up a large number of those caused by problems in care, showing the need to continue to focus on improving all care, including end of life care.

By collecting this data and taking action in response to failings in care, NHS trusts and foundation trusts will be able to give grieving families an open and honest account of the circumstances that led to a death. This work is already happening in some parts of the NHS, for example at University College London Hospitals NHS Foundation Trust, which recently held its first memorial service for those who have died in its care.

The data will allow trusts to learn from every failing in care, and then share lessons across the NHS to better protect patients in the future. For example, the Pennine Care NHS Foundation Trust, which as part of the Greater Manchester Partnership is working across Greater Manchester on mortality reviews, so that lessons learned are shared with other providers for the good of patients across the area.

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Safe staffing and equality have been an issue since the start

Parliament passed the Nurses Registration Act in 1919.

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State registered nurse

A new exhibition charts the history of nursing from the Nurses Registration Act to modern-day.

In the centenary year of nurse registration, a new exhibition charts the history of the journey from the Nurses Registration Act in 1919 through to the modern-day.

Called ‘Wake up Slackers! The great nursing registration controversy’ the exhibition looks at the heated arguments around the official registration of nurses through the first registration of men, overseas nurses and one of the first nurses to be struck off.

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The Royal College of Nursing (RCN) was just three years old when registration first happened and securing this had been part of its founding ambitions.

The exhibition shows how many of the discussions and controversies of the past, including safe staffing, continue today and influence many of the discussions around modern nursing.

The Nurses Registration Act.

The exhibit contains artefacts from the RCN archive including invites to member meetings to discuss the College’s proposals for state registration, House of Commons Parliamentary debates during the year the Nurses Registration Act was passed in 1919, as well as drafts of legislation.

Opening during Black History Month, the exhibition also showcases the story of Eva Lowe, one of the first known black nurses on the register. Research shows how, despite being well qualified she was rejected many times before finding employment. It shows how she received vague and unsatisfactory excuses for her rejection, some based on false concern for her welfare.

As well as letters and documents from the RCN’s own archive, the exhibition will also feature items loaned from other collections such as that of the regulator the Nursing and Midwifery Council.

Are nurses born or made?

Frances Reed, Events and Exhibitions Co-ordinator at the Royal College of Nursing said: “It is incredible today to think that 100 years ago there were arguments about whether or not nurses should be registered.

“Today it seems unthinkable for somebody with such responsibility for the welfare of patients not to be registered and yet there were strident clashes over it, despite other health professions securing regulation well before nursing.

“The story of the first black nurse on the register, Eva Lowe is important to highlight too. There is little known about black nurses whose names are on the very early 1920s registers.  It is essential we recognise that their contribution to health care existed well before Windrush.

“It’s also particularly striking to see how hard Eva Lowe had to fight to become the first black nurse on the register, and how 100 years later racial inequalities still exist in the health and care system.

The exhibition runs at RCN HQ in Cavendish Square, London 17 October – 20 March 2020

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Education

One in six nursing associates drop out before qualifying, finds report

Despite this trainees showed “high levels of enthusiasm and commitment to the programme”.

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Group of nurses in meeting

Only 65% of trainee nursing associates said they planned to work as a nursing associate once qualified.

An independent evaluation of the nursing associate role commissioned by Health Education England (HEE) has found that while there are “high levels of enthusiasm and commitment to the programme”, one in six nursing associates are dropping out before completing the course.

Attrition rates for trainee nursing associates fell slightly below that of student nurses, with 18% leaving before completing the course.

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While ill health and personal issues were some of the most common reasons for leaving the programme, nearly a quarter (23%) withdrew because they failed to meet the academic requirements of the programme – with numeracy skills cited as a key issue.

One trainee said they found the “attitudes towards the role and the negative feedback about Nursing Associates” challenging.

Only 65% of trainees said they intend to continue working as a nursing associate once qualified as the programme is often seen as a stepping stone to becoming a registered nursing.

Highlighting challenges.

Mark Radford, Chief Nursing Officer, Health Education England said the report “highlights some challenges that we must address to ensure that students such as ensuring the quality and oversight of placements, attrition and numeracy support.”

“We also recognise that further work and research is required to ensure that the profession is supported and utilised in the workforce of health and social care as part of the MDT. I am pleased to be able to report that we are in the process of identifying candidates to be considered as NA ambassadors across England.

Commenting on the report, Andrea Sutcliffe, Chief Executive and Registrar for the Nursing and Midwifery Council (NMC), said; “Having had the pleasure of meeting many nursing associates across the country, I am continually inspired by their enthusiasm and dedication for providing care and they should be very proud of the difference they make for the people they support.”

“I look forward to seeing how nursing associates continue to develop and be supported in their work, long into the future.”

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