Nurses to make hourly rounds under Cameron plans Nurses will be told to undertake hourly ward rounds and members of the public will be allowed to inspect hospitals, under plans to be announced by David Cameron. The prime minister believes most patients are happy with NHS care but there is a "real problem" to be put right in some hospitals, with people not getting food and drink or being treated with respect. A Care Quality Commission report has expressed concern about dignity and respect in hospitals throughout the country. The prime minister will make a speech unveiling the full package of measures on Friday. He will pledge to strip away "stifling bureaucracy" and allow nurses to focus on what they do best, saying that the whole approach to caring needed to be reset. He will also emphasise the need for leadership on wards, saying people want to see a figure of authority, whether they were called matron, ward sister or team leader. In October the Care Quality Commission found a fifth of NHS hospitals were breaking the law on care of the elderly. Its study also found half of hospitals were failing to provide all-round good nutrition to elderly patients while 40% do not offer dignified care. Of 100 hospitals investigated in England, 49 were found to generate minor, moderate or major concerns about nutritional standards for elderly people. Cameron wants nurses to focus on "patients not paperwork" while all hospitals will be expected to implement regular ward rounds "to systematically and routinely check that patients are comfortable, are properly fed and hydrated." A new Nursing Quality Forum of frontline nurses and nursing leaders will be tasked with promoting excellent care and ensuring good practice across the NHS. Patients will lead inspections of hospital wards, with local people becoming part of teams assessing cleanliness, dignity and nutrition. A "friends and family test" will ask whether patients, carers and staff would recommend their hospital. The results will be published and leaders of hospitals who fail the test will be held to account. "If we want dignity and respect, we need to focus on nurses and the care they deliver," Cameron will say. Somewhere in the last decade the health system has conspired to undermine one of this country's greatest professions. It's not one problem in particular. It's the stifling bureaucracy. The lack of consequence for failing to treat people with dignity. Even, at times - as we saw with Mid Staffordshire - the pursuit of cost-cutting or management targets without sufficient regard for quality of care. Nursing needs to be about patients not paperwork. So we are going to get rid of a whole load of bureaucracy that stops nurses from doing what they do best. And in return patients should expect nurses to undertake regular nursing rounds - systematically and routinely checking that each of their patients is comfortable, properly fed and hydrated, and treated with the dignity and respect they deserve. This happens in the best hospitals. In some it has never stopped happening. Now it needs to happen in every hospital. And the Royal College of Nursing support us on this and we'll be working with them to make it happen. Under the plans, an NHS Institute Time to Care initiative will be rolled out with the aim of cutting paperwork. More than 60% of NHS acute trusts are already implementing the programme, which has helped nurses to spend an extra 500,000 hours with patients in one year, according to information from Downing Street. The aim is to have all hospitals implementing the programme from April 2013. Evidence shows that regular nurse rounds enable patients to talk to a nurse at least every hour and a ward sister at least twice a day. Where regular rounds have been implemented, evaluation suggests they improve patient safety and satisfaction, reduce anxiety and make shifts less stressful for nurses. In another development, hospitals could receive bonus payments of up to 0.5% of their contract income if they use a new NHS Safety Thermometer to improve quality on basic care. Dr Peter Carter, Royal College of Nursing chief executive and general secretary, said: "Nurses working in every field have one thing in common - they chose the profession because they want to care for people. The profession will welcome the moves to free up nurses to put care first, and to focus all their energies on the needs of their patients. In particular, nurses themselves have emphasised the enormous burden of the paperwork they have to complete, day in and day out. Katherine Murphy, chief executive of the Patients Association, said: "This is a significant step forward in meeting the demands of our Care Campaign, launched in November last year. But we are disappointed that it has taken intervention at this level to bring about the change that is desperately needed. We have consistently said that nurses need time to care, and we have called for an end to the bureaucracy that stops effective nursing. The shadow health secretary, Andy Burnham, said: "If David Cameron really wants to help nurses focus on patient care, he should listen to what they are saying and drop his unnecessary health bill." Jo Webber, deputy policy director at the NHS Confederation, told BBC Radio 4's Today programme that the amount of paperwork required from nurses varied from hospital to hospital. I think the first thing hospitals will do in any case is to do an audit of what nurses are actually doing and to try and pare away those tasks which are mundane and routine and can be done by, say, ward clerks.