The long-awaited Francis report’s fundamental purpose was to influence government to change healthcare to ensure the public’s safety. Its purpose was to make sure that a Mid Staffs scandal can never ever happen again.
The question of how many of those 290 recommendations the government will implement remains to be seen - the prime minister is positive about mandatory training for healthcare assistants but lukewarm about regulation; they are trying to “sweep away” the outmoded way the Nursing and Midwifery Council operates but unclear how to resource the increased duties afforded to the regulator for revalidation.
But many of Robert Francis QC’s recommendations will count for nothing while nurses are still overstretched and understaffed.
Now don’t misunderstand me. What happened at Mid Staffs was inhumane, inexcusable treatment of patients. The way patients were spoken to, deprived of food and drink and left in soiled beds was more to do with a lack of compassion than a lack of nurses.
Our understaffing survey featured heavily in the media. This reveals public concern. They know a main factor in the provision of quality care is having adequate staff
But we do know that frequently nurses feel unable to spend time with their patients, talking to them, finding out if they are comfortable and how effective their pain medication is. They are struggling to help their patients get to the toilet, wash or eat, especially on wards with lots of older people who are highly dependent.
Our survey on understaffing in last week’s issue showed 76% of the 595 nurses who responded felt their wards were “dangerously understaffed” “sometimes or always”. This survey featured heavily on the BBC, Sky, ITN and a host of national and local radio stations and newspapers. This reveals public concern. They know one of the key factors in the provision of quality care is having adequate staff.
Mr Francis’ suggestion that NICE tools are used to evidence staffing ratios and numbers is a good start, and let’s hope this leads to a sensible conversation - and more importantly - action.
The evidence Mr Francis heard at the public inquiry, including from the then chief nursing officer for England Dame Christine Beasley, was pretty equivocal on staffing numbers.
She claimed that setting such numbers would mean they would become the “ceiling not the floor”. Fair point, but in some trusts, that would still be an improvement.
Many trusts continue to cut nursing posts and replace qualified nurses with unqualified HCAs. If Francis is to have a real legacy for public protection, then making sure the service gets enough people to do the job - and do it well - should be non-negotiable.
Jenni Middleton, editor
firstname.lastname@example.org. Follow me on Twitter @nursingtimesed