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Francis report: the key 'themes' for nursing

The Mid Staffordshire Foundation Trust public inquiry report made a range of recommendations affecting nurses and nursing.

Inquiry chair Robert Francis QC’s “key themes” affecting nursing are summarised in chapter 23 of the report. They are as follows:

  • The evidence shows that a completely unacceptable standard of nursing care was prevalent at the Trust and that this caused serious suffering for patients and those close to them.
  • The decline in standards was associated with inadequate staffing levels and skills, and a lack of effective leadership and support.
  • Nursing staff at the Trust did not receive effective support or representation from the Royal College of Nursing (RCN).
  • The aptitude and commitment of candidates for entry into nursing to provide compassionate basic hands-on care to patients should be tested by a minimum period of work experience, by aptitude testing and by nationally consistent practical training. Effective support and professional development for nurses should be made the responsibility of professionally accountable responsible officers for nursing, and, in due course, reinforced by a system of revalidation.
  • The capacity for front-line nursing leadership needs to be increased by enhancing the role, by better support and professional development resources, by placing leaders at the centre of teams caring for patients, and by identifying nurses with personal responsibility for each patient.
  • The leadership required for the delivery of excellent nursing care should be recognised and incentivised in the remuneration structure by more explicit reference to the delivery of excellent care, and by use of professionally formulated and accepted performance measures.
  • The specialist skills, commitment and compassion needed for the nursing care of the elderly should be accorded the recognition they deserve by creation of a specialist registered status.
  • There is an inherent conflict between the professional representative and trade union functions of the RCN which may diminish the authority of its voice on professional issues.
  • It is important that the strength of the nursing voice is not diminished by the transfer of the post of Chief Nursing Officer to the NHS Commissioning Board. That voice could be further strengthened by a requirement that all organisations in the healthcare system for which nursing issues are relevant had the advantage of a nurse at board level.

Source: Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry Volume 3

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