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Mid Staffs report to spark NHS 'culture change'

Patients must be “treated as human beings” and not as numbers, the health secretary has said ahead of a high profile report into the care failings that took place at Mid Staffordshire Foundation Trust.

Jeremy Hunt’s comments come ahead of the £11m review of what went wrong at Stafford Hospital between January 2005 and March 2009.

Writing in the Sunday Telegraph, Mr Hunt said the NHS needed a “change of culture”.

“Patients must never be treated as numbers but as human beings, indeed human beings at their frailest and most vulnerable,” he wrote.

“A culture of targets and performance management defined the NHS under Labour - with the unintended and tragic consequence that organisations cared more about meeting top down targets than focusing on the needs of patients.”

In 2009 the Healthcare Commission revealed a catalogue of failings at Mid Staffordshire Foundation Trust and said “appalling standards” 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.

The public inquiry, led by Robert Francis QC, is due to submit its report to ministers this month.

It was commissioned in 2010 after an election pledge from the Conservatives to hold a public inquiry. A previous independent, but non public, inquiry into events at the trust found it had “routinely neglected patients”.

Mr Hunt added: “We are rightly proud of the core founding values of the NHS, particularly that no one, regardless of income, should be deprived of the best care.

“These failings of basic human compassion represent perhaps the most shocking betrayal of NHS founding values in its history.

“And a betrayal of the vast majority of doctors, nurses and care assistants who joined the profession because of their innate compassion and humanity.”

Readers' comments (22)

  • I hope you all don't believe Mid Staffs is the only place where poor managers have been responsible for being distracted by targets in the interests of cost cutting whilst ignoring the warnings of risks to patients on behalf of highly trained frontline clinical staff. These staff brave enough to raise their concerns were revenged by managers and a culture of fear emerged in which pressure was piled on staff to put the demands of managers before the needs of patients. When things inevitably went wrong it was hidden from patients thus there was no duty of candour. We need proper accountability from NHS managers and we desperately need a change in culture with "openness and transparency when things go wrong". The founding values of the NHS are being betrayed in individual NHS trusts by managers who are not qualified but more importantly do not care about patients. Please do not believe the rhetoric which states patients are at the centre of all we do.

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  • I am currently trying to complain about the care of a relative. As a nurse myself I couldn't agree more with the comments above. Anonymous 7-Jan-2013 12:29 pm

    I was advised to raise my concerns with the line manager who arranged for a meeting with my sister and myself. We did actually feel we were getting somewhere until we received her letter supposedly detailing our concerns. It omitted the main thrust of our complaint and although she acknowledged other concerns nothing has been done.
    The line manager knows very little about the day to day work of the staff member we are complaining about. We intend to pursue our concerns but it is tiring and time consuming. Our overwhelming feeling is that if they string us along long enough we will go away......... We won't. I feel not only is a duty owed to my relative but also to the many excellent staff in the NHS who sadly often get tarred with the same brush as the uncaring incompetents.

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  • Anonymous 1:25pm.

    Depending on the severity of your complaint about the member of staff (and if they are a qualified nurse), you could always take your complaint to the NMC. The other option could be to report the concern (again if applicable) to the CQC or advise the Trust, if nothing is done, you will raise this with the CQC. Might make them sit up and take your complaint seriously.

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  • michael stone

    I have not read the piece above, but wanted somewhere to put something I've just read in today's Guardian (page 4).

    Hunt is reported to have said "And that means above all happy and motivated staff".


    Then he went on with: 'the NHS "must ensure that training for nurses and care assistants helps them cope with busier wards"'.


    Apparently he also added "and that the compassion that led them into the profession does not get ground out of them".

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  • with all the cutbacks and job losses started by this incompetent govt im afraid this is going to happen all over again

    posts are being lost on a daily basis, morale is at rock bottom

    when will this shower of idiots realise you carnt run a ward without adequate staffing

    lets hope labour get back in power in 2015, at least they looked after the nhs, not privatised it like this lot

    thatcher wanted to scrap the nhs, cameron and clegg are just doing what she wanted

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  • Thank you Carol. We have considered some of those options.
    Maybe with the publication of this report it may make Trusts sit up and take notice. It is certainly something I will highlight with this particular Trust.

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  • Anonymous | 7-Jan-2013 2:52 pm

    it is the labour party who have got the NHS in such a mess!

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  • PLEASE can we all stop blaming everybody else! - the staff, the managers, the government (whichever one it may be at the time!), what has happened was awful, but it has happened and now we all need to work together to try to make sure this can't happen again. We need to make sure that where poor practice is evident, that is not tolerated by front-line staff. I hate to sound like a broken record, but as clinicians we are accountable for our OWN actions and OMISSIONS! I do not underestimate the pressures on wards, in care homes or in community but there IS something we can do about it - we are NOT powerless and I applaud our colleague above who has identified poor practice and isn't going to rest until something is done about it! Have people so quickly forgotten three very useful and underused tools called "Risk Assessment", "reporting untoward incidents" and "Essence of Care Benchmarking Patient-focused benchmarking for healthcare practitioners" (Originally issued by the DOH in 2001 but updated and re-issued in 2003 and 2010) - Maybe the NT could do some articles reminding clinical staff how to make the most of these tools as they can and do empower staff to DO SOMETHING! Dust these tools off and get them used - if you are not sure what to do with them get your local Union Learning Representative to help you - but above all support each other, fight to maintain credibility in the profession and don't let poor practice get a foothold. As mentioned we also have other allies out there, we are NOT alone - So long as you have documented and reported your concerns appropriately and in accordance with Trust or local policy, we can seek advice from CQC, LINks (Local Involvement Networks) soon to become Healthwatch (after April 2013) and the Patient's Association - the more we have public support and involvement in healthcare, the more support we will have to change policies and practices that don't work or put patients at risk. One final word - PLEASE seek out and make friends with your local commissioners! Like you - they want what is best for their local population and they will work with you to try and change things - at the end of the day managers have to listen to commissioners as they are the ones holding the purse strings!!!! Seek help - It can be a lonely road - but you are not really alone.

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  • Feel this needs to be considered in relation to following info, amongst others:

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  • "Managers" include puffed up so called nurses!

    These people who delight in titles such as "Director of Nursing" are complicit in the reduction of numbers of professional clinical nurses , the weakening of skill mix achieved by the employment of unskilled, unqualified care assistants.

    These "managers" have also piled up the tick box paperwork --- to such an extent there really is no time left for patients!

    "Directors of Nursing" also refuse to accept the increase in patient acuity ! They believe old ladies with dementia are easily cared for within the confines of acute wards ! and that additional staff is needed to ensure safe care ------

    In every case where poor care is identified the responsible "Nurse manager" should be suspended and subject to a "fitness to practise" enquiry.

    If where you work patients are at risk because of poor staffing levels or inadequate skill mix report your concerns NOW ! This is the best time !--Send incident forms direct to the trust CEO and at the same time tell the CQC your patients are at risk.

    They will not dare to bully --- they are all quaking in their boots -- terrified of what Robert Francis' will demand. For sure he will be going after the "Bosses".

    This is the moment for clinical nurses to strike back ------do it and tell how it really is !

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  • michael stone

    Anonymous | 7-Jan-2013 8:08 pm

    'We need to make sure that where poor practice is evident, that is not tolerated by front-line staff.'

    Yes - first, open your eyes so that you can spot 'poor practice', then do not tolerate it.

    And keep pushing, until sensible safeguards are put in place to allow staff to criticise poor practice, without then be 'bullied' by some very bad managers !

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  • you are all living in cuckoo land. When frontline experienced clinical staff dare to report unsafe practices which management are responsible for the certainty is these staff will be punished one way or another. The majority of managers are incompetent. They micro manage because they lack confidence due to their lack of ability this results in them punishing staff who dare to expose them when raising concerns. Until the culture is radically changed this will continue so for all your sakes do the best you can for your patients but whatever you do do not raise your head above the parapet. .

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  • michael stone

    Alan Milburn, the former Health Secretary, has written a piece in today’s Times (page 20) and some extracts follow – I especially like the final sentence !:

    Patients should be able to make choices based on actual experiences of other patients. In other walks of life the power of the crowd helps individuals to do just that ….

    Openness drives improvement. So too does public participation. In New York today more than 90,000 citizens routinely call a special number to let authorities know in real time whether bins are being emptied or potholes repaired. The responsiveness of services has improved markedly as a result.

    If patient feedback on the NHS was routinely collected and published it would act like a smoke alarm to detect service failures. It would also highlight patients overwhelmingly getting good care, not bad.

    This journey has already started. David Cameron wants the NHS to introduce a friends-and-family test from April so that future patients can see whether previous patients would recommend a hospital's services. In the light of the Francis report the Prime Minister should go further. He should insist that real-time, open reporting from patients and their carers becomes the norm across the whole of the care system by the time of the next election.

    The shocking treatment that patients suffered at Stafford is a stain on the reputation of the health service, not least because NHS standards of care are usually high and have seen big improvements over recent years. With the best will in the world, regulators' eyes cannot be everywhere. But patients’ and carers’ eyes can.

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  • "Patients should be able to make choices based on actual experiences of other patients."

    no two patients will have exactly the same experiences and choosing something based on the experience of another patient could well act against their best interests and even be dangerous. Health care is all based on an à la carte menu!

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  • tinkerbell

    somebody posted the francis report link, can't find it now but thanks.

    Read it. Absolutely abysmal to read the catalogue of dehumanisation and the fact the abuse/neglect went on for so long.

    These managers weren't even fit to look after a plant let alone another living, feeling, breathing, vulnerable, human being.

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  • tinkerbell

    where do these bullies get their power, from cowards.

    Are some nurses prepared to take home their wages off the back of someone elses suffering?

    We need whistleblowers to unite, tell it like it is regardless of consequences or anothers status. What status have these managers got in corrupt organisations. We who are doing our best to provide compassionate care should be making their lives as difficult as we can and it will still be no where near the suffering of a vulnerable patient left to rot in their bed in a so called hospital within a so called caring profession.
    Where was everybody who witnessed this appalling treatment that they couldn't mobilise en masse and stop it when they could have joined forces and made all the difference.

    And change the term 'whistleblower' to somethng with a more positive connotation
    like 'ethical crusaders'.

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  • Mid Staffs transcripts:

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  • michael stone

    tinkerbell | 8-Jan-2013 7:20 pm

    'And change the term 'whistleblower' to somethng with a more positive connotation
    like 'ethical crusaders'.'

    GREAT IDEA - that one should be acted on !

    I'm going to pass that on to my DH contact, although she doesn't directly do 'whisleblowing'.

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  • DH Agent - as if ! | 9-Jan-2013 10:27 am
    for goodness sake, there is too much meaningless jargon as there is and nobody knows what half of it means anyway - except perhaps the managers who have learned the lingo.

    incidentally if you ever turn up on a ward I imagine you would seriously hamper the progress of any nurses' work getting done at all.

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  • tinkerbell

    Anonymous | 9-Jan-2013 11:16 am

    I can assure you that it isn't meaningless jargon to be a 'whistle blower', i have been one and i would truly like to get rid of that particular terminology.

    They try to use the term against you, hound you out of the profession and ensure that no one ever takes you seriously again.

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