The Chief Medical Officer’s Report published in March 2010 and this article summarises some of its contents. Since Sir Liam Donaldson took office in 1998, his reports have helped bring about legislative and other changes to policies including governing embryonic stem cell research, smoking bans and consent for organ and tissue retention. Under his leadership we have seen reforms to the structure and functioning of the health service with the establishment of the National Patient Safety Agency, the Health Protection Agency and the Expert Patient’s Programme. It is unsurprising that after such a long time in post he has stepped down. The interim CMO is Professor Dame Sally Davies.

 

Although Sir Liam’s final report focused heavily on the flu pandemic and alcoholism, he also concentrated on the continuing need for improving NHS healthcare services.

In the wake of Lord Darzi’s report “High Quality Care for all”, the NHS has been collating data to produce ‘Quality Accounts’ for 2009/2010. Using the data, trusts will report key measures of quality just as they have been reporting key measures of financial performance. In a year which saw Stafford and Basildon University Hospitals hit the headlines, he noted the volume of clinical errors reported to the National Patient Safety Agency.  The departing MHO was clearly a great fan of checklists. A pilot scheme of the WHO’s Surgical Safety Checklist in London hospitals reduced the risk of death and post surgical complications “significantly”. Its use has now been advocated on a nationwide basis. The 2009 intensive care unit checklist has also been implemented in 80% of hospital trusts in England.

 

Few of the new health topics addressed in his report relate specifically to clinical negligence practice. Sir Liam has recommended a series of actions to increase prevention and detection of rare diseases. Relying on studies which suggested that between 33 – 40% of people with a rare disease are initially misdiagnosed on the UK, he advised that there be better coordination of specialist services and that the network of reference centres for rare diseases be strengthened. He advocated the appointment of a National Clinical Director for rare diseases and a national register to support service planning and research.

 

At a local level he turned his sights to the North West of England where he found a stark difference in mental well being across the region. Health, lifestyle, personal relationships were all found to play their part. Liverpool scored lowest though he cited a recently launched mental health strategy and a 2010 multi agency campaign to engage people and enterprises in doing more to improve health and well being.

 

He seemed relieved to be leaving his successor to deal with the obesity health time bomb and the health impacts of climate change. We wait to see how the next MHO deals with this and Sir Liam’s un-implemented recommendation from 2006 of an ‘opt out’ organ donation system to prevent the continuing and needless deaths of those awaiting transplant.