Lord Darzi’s Report and the future of the NHS workforce

June 30, 2008

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HIGH QUALITY CARE FOR ALL: NHS NEXT STAGE REVIEW FINAL REPORT

“An NHS that gives patients and the public more information and choice, works in partnership and has quality of care at its heart.

Dear Prime Minister, Chancellor of the Exchequer, and Secretary of State for Health,
This year the NHS is 60 years old. We are paying tribute to a service founded in adversity, from which were established enduring principles of equal access for all based on need and not ability to pay. We are celebrating a national institution that has made an immeasurable difference to millions of people’s lives across the country.

Quite simply, the NHS is there when we need it most. It provides round the clock, compassionate care and comfort………”

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A HIGH QUALITY WORKFORCE: NHS NEXT STAGE REVIEW

“The role of the doctor

25. In his Inquiry report into Modernising Medical Careers Aspiring to Excellence, Professor Sir John Tooke highlighted the importance of reaching a consensus on therole of the doctor. This challenge has already been taken up by the medical profession itself, with the Medical Schools Council, Royal Colleges, NHS Employers and the BMA working together to address this issue. This is something that the Department of Health supports.

26. As described in High Quality Care For All, there are significant changes underway in all advanced healthcare systems. Together, these changes mean that quality is a moving target – to stand still is to fall back. It is for these reasons that expectations of the role of the doctor are changing too.

27. Recent debate within the medical profession has already identified a number of distinctive features relevant to trained doctors as expert medical practitioners. NHS patients and the public expect their doctors to:

achieve accurate and timely diagnoses

ensure the safety of patients

help patients navigate through the healthcare pathway(s)

contribute appropriately as a leader of or partner in the clinical team

contribute to healthcare research, development and innovation

train future generations of healthcare professionals

28. They recognise that doctors are vitally important because of their core skills in:

leadership

dealing with complexity and managing uncertainty

effective and efficient problem solving

working with patients to take legitimate risks and effectively managing risk by providing information alongside professional judgment to maximise patient independence and choice

grasping clinical situations intuitively based on a deep, tacit understanding of their area of practice

29. Within the medical profession, plans are already in place to take these ideas forward. This work will take account of perspectives of patients and employers as well as other healthcare professional groups. We will work with leaders of the profession to ensure that medical education and training supports the development of the identified characteristics in tomorrow’s expert medical practitioners.”

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