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Francis report must lead to more 'patient-centred' care, say NHS managers

The public inquiry into failures to prevent routine neglect at a scandal-hit NHS hospital must lead to a more “patient-centred” health service, a body representing NHS managers has urged.

The head of the NHS Confederation said Wednesday’s publication of the Francis report would rightly expose failings which led to what a previous independent inquiry described as “appalling” standards of care.

The confederation’s chief executive, Mike Farrar, pledged that NHS leaders would respond positively to the report and work to change the culture of the NHS.

Predicting that the release of the report would be “one of the darkest days” in the history of the NHS, Mr Farrar acknowledged that changes needed to be made to make patient feedback easier and give the public a clearer picture of how local services were performing.

He said: “Our failings in Mid Staffordshire will be laid bare - and rightly so.

“The people in charge of running our health services should rightly be held to account when they fail to act in the interests of patients.”

But Mr Farrar warned: “What we don’t want is a simplistic blame game, excessive inspection or micromanagement.

“These are false gods that externalise problems rather than putting responsibility where it belongs - in the board room and on the frontline.

“They suck up resources and encourage tick-box responses, not real culture change.”

It is understood the inquiry chairman, Robert Francis QC, will recommend wide-ranging reforms of the NHS.

The £11m review of what went wrong at Stafford Hospital between January 2005 and March 2009 will suggest hospitals that cover up mistakes by doctors and poor treatment of patients should face fines and possible closure, it has been reported.

A separate highly critical report by the Healthcare Commission in 2009 revealed a catalogue of failings at the trust and said it had put patients at risk.

Between 400 and 1,200 more people died than would have been expected in a three-year period from 2005 to 2008, the commission said.

In February 2010, an independent inquiry into events at the trust found it had “routinely neglected patients”.

The latest public inquiry, announced by then Health Secretary Andrew Lansley in June 2010, was set up to examine the commissioning, supervisory and regulatory organisations in relation to their monitoring role at Mid Staffordshire Foundation Trust between January 2005 and March 2009.

The inquiry was asked to look at why the serious problems at the trust were not identified and acted on sooner, and to identify important lessons for the future of patient care.

Stafford-based campaign group Cure the NHS, which includes relatives of patients affected by poor care and other community members, successfully lobbied the coalition government for a full public inquiry.

Speaking ahead of its publication, Cure the NHS member Ken Lownds said: “This has been a desperately long fight for Cure the NHS and very emotionally draining.

“We know Robert Francis will have done an excellent job of analysing the mountains of evidence that he has amassed, but we believe the truth about the sham and charade that was the last Labour government’s attempt to regulate the NHS, will at last be fully exposed.

“We believe that very many senior civil servants and bureaucrats in all of the health regulators should have apologised and resigned a long time ago.

“In the blueprint for a new NHS which we submitted to the inquiry, we set out how the NHS should now begin to pursue ‘zero harm’ as its commitment to every patient it treats.

“We sincerely hope that Robert Francis will have made that one of his key recommendations.”

Dean Royles, director of the NHS Employers organisation said the health service would be responding to the report at the same time as it was undergoing seismic changes.

“Getting these changes right will require excellent staff engagement so we can bring about the service change we need for a sustainable and compassionate NHS,” he said.

Meanwhile, the leader of Staffordshire County Council has called for the voice of the public to be at the heart of delivering an invigorated NHS.

Ahead of the publication of the Francis Report, Philip Atkins said residents must be listened to if the NHS is to truly learn from the events which unfolded at Stafford.

Mr Atkins said: “If as a country we are really serious about transforming the NHS, then the voice of the public needs to be the driver for change and sadly we need look no further than Stafford Hospital to see why this must happen.”

 

Do you want to keep up to date with the latest from the Francis Report into the Mid Staffordshire Foundation Trust? Visit our tailored Francis Report channel with the latest rolling news and analysis

Readers' comments (13)

  • I wonder if demands for the revalidation of nurses will become more persuasive to government? I assume the argument will be along the lines of "if it's necessary to ensure safe practise by doctors, then why not nurses"? In the current climate, it's very hard to make a case against it.

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  • Yes But

    'patient-centred' is pretty meaningless, because it is too open to interpretation.

    What is needed, is the:

    the voice of the public needs to be the driver for change

    bit - listening to patients and their relatives, when assessing services.

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  • The voice of the public must be listened to, but what the voice of the public needs to remember is that good services cost money and that money inevitably comes from taxes. A public that consistently votes for whoever promises tax reductions (and I'm not pointing at any political Party/Government) is partially responsible for the priorities that Government then takes in terms of public expenditure.

    Personally I'd be happy with a higher basic rate of income tax if I could be certain it is being spent wisely.

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  • Tiger Girl

    Anonymous | 4-Feb-2013 12:48 pm

    Yes, your observation is correct - as is the observation that politicians in office, almost never admit that spending less will perhaps reduce the level of the sevice provided: when did you last hear a Health Secretary say "We can't spend as much in future, so the NHS will perhaps provide worse care than previously'?

    More transparency and openness, is one requirement to address this apparent paradox.

    Although the current clamour is not about the voice of the public (you get that at elections) but is instead pro the voice of the patient. The patients, relatives and ward staff were all apparently complaining about events at Mid Staffs, but were silenced or ignored at the time.

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  • ...“patient-centred” health service, a body representing NHS managers has urged."

    it has taken managers an awfully long time to cotton on to what nurses have been trying to practice and have been telling them for years. why has it taken them so long and after so much damage to realise that this is what health care is all about? nurses are experts in 'patient centred care' so is this just a reminder from managers to themselves? does this mean now they may consider taking this concept on board they will be able to support nurses and provide them with the resources they need to continue with their 'patient centred care' because without the collaboration of their managers this is becoming well-neigh impossible and patients will become less and less well cared for!

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  • Tiger Girl

    Anonymous | 4-Feb-2013 3:58 pm

    I think it was the head of the NHS Confederation, who has recently said 'we definitely do not need more tick-box regulation' for this 'culture change/patient feedback' thing.

    Nurses are closest to patients - if you honestly want to 'listen to what patients are telling you', then nurses 'reporting upwards' the atmosphere on the wards, has to be at least a major part of the solution to things like Mid Staffs, surely!

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  • 'Patient-centred care'? What a buffoon. We don't have patients, we have service users.
    All service users need are a suitably wishy-washy mission statement on a logo that has been designed in 10 minutes on the back of an empty packet of organic soya at the cost of £100,000 by some Notting-Hill type in a black turtle neck, in bright colourful letters on every available wall, floor, ceiling, napkin, paper cup in some grand stainless steel and blonde oak entrance hall containing a WHSmith, a Starbucks and a contemporary statue in the middle of the obligatory fountain, in a new building that looks like the office block from the future ( if it was designed in the 1950's) that costs the public 200 times the cost of building it in the first place, and means the Trust no longer has the money to open all the floors and employ the housemaids, butlers and concierges that a service user expects in the first place.
    'Patients' are sick people that require a bed in a hospital, with Drs and nurses to plan and provide their care when they are ill. It'll never catch on.

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  • Interesting that NHS Managers have jumped in and taken on 'putting things right', to exonerate them of any blame.

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  • B R | 6-Feb-2013 11:21 pm

    well they have to somehow justify the 'lessons have been learned'and cameron's 'its the right thing to do'!

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  • more than 18 yrs ago i was lucky to be financially able to leave my nursing post at one of the basildon and thorrock hospitals (now in trouble in south London.)
    i left adult nursing because i could see a marked deterioration of standards of care, not as exteme as those in stafford but i would be very wary of allowing any of my family to go to the hospital i left.
    i felt very strongly at the time that trying to feed more than 2 elderly patients at the same time was impossible and feeding two plus giving out lunchtime medicines to 16 others, leaving two or more to eat cold dinners, while trying to keep track of elderly confused and wandering patients and provide emotional support to newly diagnosed oncology patients was an impossible task.. the final straw was when i was carpeted for asking relatives to come at meal times to feed their family members.. the families needless to say loved it and were happy to feel needed and be able to do something practical for their relatives and the ward staff...
    the management were unsympathetic and gave only criticism to frontline staff..
    my complaints were ignored or dismissed and i was considered a trouble maker as everyone else was apparently managing!!!
    i left. the RCN had no whistle blowing service then... and this was not long after Graham pink was still fighting his corner for whistle blowing ..
    i'm not sure adult care has improved much and i am lucky i now work in a hospital where patient care does come first and while we may have to battle management but when it comes down to safety we can close the ward temporarily to reduce the workload, increase the staffing levels or discharge/ transfer children to other areas...
    i feel desperately sorry for all the front-line staff and patients at Stafford and hope this will be resolved to keep the patients safe and cared for.

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  • I don't understand the issue with relatives helping with basic care if both the patient and the relative wish it and give their agreement. it is a perfectly natural thing to do and in some of Med. countries this is what is expected. I also agree it should never be abused and used as a substitute for nurses carrying out their duties.

    I tried to help the nurses looking after my Mum in a private clinic and they always seemed rather reluctant, which although they were very good, caring and friendly did taint the atmosphere a little as I wanted to feel more involved and perhaps they should have been more sensitive to my needs.

    I just think in British society there are very negative interpersonal issues and people still have difficulties interacting in a natural and spontaneous manner in whatever capacity with strangers and can even be quite cruel such as in the NHS and among staff who one relies upon to be supportive of one another and able to exchange information freely and without judgement about their patients. There is too much detail to go into but my first poor experience of this was as a student on obstetrics where my ex-flatmate was hospitalised and the whole yarn spun about her by the ward sister at report which was very negative and totally untrue and all based on her own warped set of assumptions which obviously influenced how the nurses handled my friend and all her anxieties.

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  • It is amazing how, as nurses, we also have so many experiences of poor care from a personal perspective.

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  • Yes but managers need to be seen to be taking the lead or else their gravy train will hit the buffers!

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