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Editor’s Comment

'Francis report must inspire positive change'

Tomorrow is one of the biggest moments for nursing, and indeed the whole NHS.

Just before Robert Francis QC publishes his report into the care failings at Mid Staffordshire Trust, a sharp intake of breath will be audible wherever you are in healthcare.

Various delays have ensured the anticipation has been building. Doubtless it was agonising for those who lost friends and family at the hospital at the centre of this inquiry.

And yet despite the delays, very few people will have read Francis’s report before it is made public.

The QC’s life has been consumed over the past couple of years by uncovering what happened and trying to decide what lessons can be learnt not only by the trust but also the wider health service and the professions within. He has taken evidence from a cast of 187 in person, with more submitting statements.

Nurses as senior as the former England chief nursing officer Dame Christine Beasley, Royal College of Nursing chief executive and general secretary Peter Carter, as well as Care Quality Commission former chief executive Cynthia Bower, former health secretary Andy Burnham and NHS chief executive Sir David Nicholson have all given evidence.

While no one knows exactly what this report will say, Francis’s first independent inquiry report, which was published in 2010 and preceded the public inquiry, divulged clues to those areas he would focus on.

He is likely to make significant recommendations about ensuring the quality of care and treatment provided is of a high standard, and will doubtless advise tightening up regulatory performance to prevent such a catalogue of errors being missed again.

This game-changing document gives everyone a chance to mourn, and reflect on their practice. And then they must decide how they can make sure such catastrophic events are never repeated.

The report must not be another document that gathers dust on a shelf. It must not be dismissed by health workers. It must not be something that dominates the headlines for a few days before falling into obscurity.

This must be the catalyst that inspires positive change. The NHS must become a consistent home for excellence. It must become a place where people feel supported to raise concerns.

Financial targets and scarce resources are not an excuse for people dying needlessly, or suffering pain and indignity.

This is the time for the NHS to recognise what is wrong and to put it right. Francis can have a lasting positive effect - but it is up to the government and the entire NHS to make sure it does.

Readers' comments (11)

  • I know how uncomfortable it will be to hear yet more tales of woeful inadequacy in the NHS and I suspect that for Nurses it will be all the more challenging.

    I am concerned that even more regulation will be the result, I can already hear people baying for someone to be accountable so then that will make more staff less inclined to get involved in case their face is in the spotlights – not easy.

    I do think that staff need ‘breathing’ time occasionally, they seem to work flat out from crisis to crisis. So different from when I ran a Ward 35 years ago - we had overlapping shifts so that we had time to communicate and teach and there were far less interventions for patients, but we also did a great deal of harm in those days that was never reported, there were huge waiting lists, massive infections, patients for TLC without discussions with family and patients, student nurses running Wards at night the list goes on……

    So for now it will be chin up, accept we don’t always get it right but the vast majority of us want to do what is best for our patients. Yesterday I was on a busy acute ward in our hospital one of the visitors came up to me and said she wanted me to know what a wonderful group of staff they were, who had been looking after her frail elderly husband for 5 weeks. She commented on how caring everyone was, especially the Health Care Assistants, how personalised the care was and how reassured she felt – I felt like sending up a big cheer and asking the Daily Mail to interview her!!

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  • tinkerbell

    'The report must not be another document that gathers dust on a shelf. It must not be dismissed by health workers. It must not be something that dominates the headlines for a few days before falling into obscurity'.

    This is my main concern and i hope it doesn't happen, i really do.

    Every individual working within healthcare should take action when they see bad practice and speak out. If they haven't got enough staff speak up. This is the only way that things will change for the better.

    No matter how drained or weary you feel from working we must take time whether it be after work or the next day or within the same week to go and see someone about our concerns, write a statement about our concerns or email someone about our concerns and always ensure they are put in writing so we can evidence that we did something for when they deny that we ever brought our concerns forward.

    This happened to me as a much younger nurse and i had nothing in writing to prove that i had ever raised any concerns to my managers and they then denied that i ever raised any. At the time i was naive enough to think that they would want to know what was happening.

    Lesson learned.

    I don't think it was that great back in the day, i witnessed some terrible abuses by uncaring staff.The only thing that encouraged me were that there were more good nurses than bad.

    In my experience there was still mostly a conspiracy of silence then but this must stop once and for all if we are ever going to move forwards so others can speak out and feel 'safe' to do so.

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  • michael stone

    Every individual working within healthcare should take action when they see bad practice and speak out. If they haven't got enough staff speak up. This is the only way that things will change for the better.

    _____________

    As Tinkerbell points out, as have various others (notably Mike Farrar), this 'culture change' has got to come from 'the level of the bedside' - it has to be ward-staff centred, leading this 'new attitude', and not further layers of 'process-based regulation' and even more forms to be filled in. The necessary 'process', is that patients, relatives and the nurses who are in contact with patients, are listened to and taken seriously - and what those people are saying, has to be in open public view, not hidden under a sheet in a dark corner !

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  • Tinkerbell

    It would be a very great surprise if there is any shelf room left anywhere to put it on!

    Joking apart, it has attracted so much public and professional attention it is highly doubtful it can just be ignored.

    Hopefully, it will be an honest and open appraisal containing the full facts with nothing left out and giving all the information needed to enable the radical changes required to improve health services nationwide.

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  • tinkerbell

    Anonymous | 6-Feb-2013 11:23 am

    Of course i hope you are absolutely right and there is no 'new shelf building budget being planned'.

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  • Hopefully somebody will oversee that all the proposed changes are implemented and in a timely manner. left to individual managers not much will change.

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  • tinkerbell

    incompetent managers are 'recyled'.

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  • tinkerbell

    http://www.midstaffspublicinquiry.com/report

    copy of report available above.

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  • Susan Markham

    Wow... well here's a post that I never thought I'd make....

    The Daily Mail actually got it right for once....

    Yeah I know what you are saying... “shut the buck up!” but it is true.

    They “DM” seems to have (temporarily) unleashed their former biased blinkered boundaries and had the balls to publish an article that attempts to seriously understand the issues raised by the Francis report.

    Harriet Sergeant seems to get to the testicles of this issue and does it more eloquently than I ever could.

    See...

    http://www.dailymail.co.uk/news/article-2274700/The-real-problem-destroying-NHS-Jobsworths-want-politicians-patients.html

    Absolutely diamond and spot-on... What I have been saying since 1974 when the Area Health Authorities and Regional Health Authorities were created. Ivory towers. Just ways to permit more wankers to suck a severe salary from the NHS.

    FYI – I hate the Daily Mail and all it stands for.... alas I have to give them Kudos for having the testicular fortitude to publish this piece.

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  • Susan Markham

    Mike Stone - DH Agent...

    Tell me... where and when did you qualify as a Registered Nurse?

    This site is called the "Nursing Times" which seems to implicate that only "Nurses" who are appropriately regulated by the NMC should discuss matters that pertain to their profession.

    It would behove you to keep your nose out unless you can actually "man-up" and state your qualifications.

    In the meantime I suggest that you keep your personal opinions exactly where they belong... in the back of your mind!

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  • michael stone

    Susan Markham | 7-Feb-2013 10:43 am

    You seem not to have looked at the options for registering with the NT site recently - you do not need to be a nurse.

    Peculiar that most of the thrust of Francis is 'the NHS wasn't listening to the patients/relatives' and yet you are resistant to the perspectives of non nurses ?

    I've stated many times 'my qualifications' and also how/why I 'got into this' on this site.

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