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RCSEd Responds to Donaldson Report

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26 May 2015

The Royal College of Surgeons of Edinburgh recently responded to the Northern Ireland Department of Health, Social Services and Public Safety’s consultation on the findings of the Donaldson Report.

An expert examination of the application of health and social care governance arrangements for ensuring the quality of care provision in Northern Ireland, the report made ten recommendations including closing local hospitals that cannot provide a satisfactory level of care needed 24/7. In response, RCSEd recommended that;

  • Any board tasked with reconfiguring the health service in Northern Ireland should look to utilise international expertise, but would need local clinical and patient input to ensure ownership.
  • Clinicians and patients should have as big a say in the final decisions as politicians.
  • Specialised services should be consolidated in regional centres of excellence in cases where the evidence shows a clear clinical benefit.
  • The commission system should be made simpler and more transparent.
  • More should be done to deliver care outside of the hospital setting. This should include an expanded role for district nurses, occupational therapists, physiotherapists and palliative care professionals.
  • More should be done to equip people with the skills to deal with help manage their own long terms conditions.
  • Any changes to the Regulation and Quality Improvement Authority must mean a renewed focus on standards in patient care.
  • Whistleblowing policies should be reassessed to ensure an open culture.
  • Any complaints system for staff or patients’ needs to be genuinely independent.
  • Wrong site surgery and foreign object implantation should be included on any list of never events.
  • A Duty of Candour should be adopted.
  • A National Institute for Patient Safety would require strong local leadership in order to be successful. The NIPS should focus on developing resilience skills during undergraduate education and postgraduate training. It should also be well placed to help develop leadership skills amongst clinicians.
  • The Department should pursue the idea of a technology hub to encourage innovation.

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