For those of you out there who are striving every day to deliver compassionate and high-quality care to your patients within the current resource and staffing constraints of the current NHS, this is an even more difficult day than usual. It is hard to hear criticism of the profession.
Without a doubt there was poor nursing care at Mid Staffordshire and at other hospitals around the country. Some of that was the result of particular individuals but as Robert Francis makes clear the problem was more organisational factors including culture, staffing levels and staff skill mix also played a significant part.
But although this is a dark day, it is also the day that brings hope that the problems in the health service which you live everyday will start to be addressed.
In his report Robert Francis makes 290 recommendations which offer a way forward for nursing in particular. The breadth and significance of these recommendations is huge for both nursing and the delivery of healthcare.
The central tenet is that “the patients must be the first priority in all of what the NHS does”.
For nurses a key recommendation is for each patient to be allocated for each shift a key nurse responsible for their care and for this nurse should be present at every interaction between the patient and the doctor.
There are recommendations for the implementation of quality metrics and the need for evidence-based tools to establish appropriate minimum staff numbers and skill mix.
Regulation and standardised training of healthcare assistants and a strengthening of the clinical role of ward managers are important steps. As is the formalisation of the nurses’ continuing professional development with an annual appraisal and portfolio to be signed by nurse and countersigned by their manager.
For these change and improvements we need both will and resources from the government to ensure that the recommendations from the report are carried through. Nurses now have a platform to articulate their concerns and have their voices heard. We need to grasp this opportunity and ensure the appalling neglect and care at Mid Staffordshire Hospital never happens again.