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Nurses should make a pledge to provide high quality services for patients to tackle the 'recent stream of high profile failures', according to the Prime Minister's report on the future of nursing and midwifery.

The review on the standard of nursing care, commissioned by Gordon Brown and chaired by health minister Ann Keen, proposes that nurses and midwives 'restate their commitment to the public and service users in a pledge to deliver high quality, compassionate care' in an attempt restore public confidence in their role.

The report highlights that a lack of communication between nurses and patients and a reluctance to blow the whistle on poor practice has lead to an increase in patient complaints against nursing staff.

The report makes 20 recommendations on how to improve standards of care provided by nurses and midwives, including:

• encouraging nurses and midwives to lead innovation in services design and delivery. The development of entrepreneurial skills should be included in pre- and post-registration training and education
• ensuring nurses have a leading role in the care of patients with long-term conditions
• acknowledging that nurses and midwives are seen as role models of healthy living and they should be responsible for their own health
• the role of the ward sisters, charge nurses and equivalent team leaders in midwifery and community settings should be strengthened to drive quality and safety, and provide a visible leadership and reassurance for patients and staff

The Royal College of Nursing director of nursing and service delivery, Janet Davies, described the report as a 'milestone for nursing' stating: 'It will direct how the profession evolves to ensure patients continue to receive high quality care in the future. What is important now is turning this ambitious vision into reality.

'Nurses will also welcome the recommendation to strengthen the role of ward sisters, who act as the linchpin between patients and management.'

Patients Association director Katherine Murphy said: 'Whilst we welcome the pledge, it's a sad indictment that there is a need to restate the commitment of nurses and midwives, the caring profession, to high quality patient care. Patients expect compassion from all healthcare professionals, but rightly or wrongly, especially from nurses.

She added: 'Whilst the pledge is a good first step, ensuring every nurse and midwife lives up to it, and more importantly are allowed to live up to it, is the only outcome patients are interested in.'

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