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Halt the blame game and find the solutions

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'Make zero harm a reality in the NHS' 'Make zero harm a reality in the NHS'

'Make zero harm a reality in the NHS'. This is the instruction issued by prime minister David Cameron to Dr Don Berwick, the former health adviser to president Obama charged with leading a brand new National Patient Safety Advisory Group in England.

This is no small challenge, and cynicism may prevail. But it is fair to say that Dr Berwick is a renowned expert in patient safety with huge respect for the NHS which he has described as 'one of the astounding human endeavours of modern times'.

As the co-founder of The Institute for Healthcare Improvement in Boston, he has worked with healthcare systems around the world and has previously advised against ongoing NHS reorganisations and greater use of market forces.

Speaking to the BBC, Dr Berwick said that if he had the chance to talk to a nurse directly, he would say: 'I know that top of your mind is doing the right thing for your patient every single moment. The hassles that get in your way, the pressures of nonsense, the waste in your work, the hurdles you're made to climb over, the machines that don't work, the space that's poorly designed, the uncleanliness that surrounds you. These are all in your way. Let's get them out of it.'

This is arguably the most 'in touch' a non NHS clinician has sounded since the Francis report was published last month. As an 'outsider' Dr Berwick has an opportunity to get to the crux of true barriers to quality care and to offer workable solutions. However, in a previous review of the NHS, his Boston Institute warned of a 'shame and blame' culture in the NHS in England, which got in the way of improving quality of care.

With that in mind, I would say let's not waste energy debating whether David Nicholson should remain chief executive of the NHS. Let's focus on innovative solutions to improving care in the most practical, and noticeable, of ways.

Sarah Wild, editor, Independent Nurse

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