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'Look beyond nursing to give Francis legacy'


This week marks a year since the publication of the Francis report and really, has anything changed?

Not much in the short term, according to our survey on page 2 and 3, although 42% of the 526 nurses who we asked believed that the report would bring about long-term positive change for the quality of healthcare provision in the NHS.

It’s pretty staggering to find that number are still feeling positive considering how browbeaten the profession has been since the report was published.

While Francis made it clear that no one professional group was to blame and that systemic failings across the board were responsible for what happened at Mid Staffordshire Foundation Trust, nurses have very much borne the brunt.

In fact, our survey reveals that a quarter of nurses surveyed believed that the report has led to unfair criticism of the profession.

The prime minister, the health secretary and countless media commentators have pointed to a lack of compassion as the cause of the failings. The most high-profile government responses to Francis have seemed to put the blame squarely on nursing’s shoulders - such as the pilot scheme where aspirant student nurses become healthcare assistants for a year. The suggestion is that nursing has the biggest problems to fix. But is that really the case?

Why have we heard so much about the nurses and the nursing directors (many of whom were at fault, I won’t deny it) but nothing about the chief executives, the board, the HR directors? Why weren’t they scrutinising patient feedback, walking the wards, looking at staff sick leave and asking all the right questions when things appeared to be going wrong?

And while we have heard about the “Francis effect” leading to increased recruitment of nurses on the wards, our survey reveals that this is not universally leading to safer staffing levels.

Last year, 57% of our survey, which we conducted just before the Francis report was published, told us their wards were sometimes or always dangerously understaffed, this year the figure has risen to 58%. Surely that - if nothing else - needs to be fixed to ensure safe patient care?

To blame nursing and only nursing is to deny what really happened at Mid Staffordshire and that will ensure Francis leaves no suitable legacy. If the health service is to fix itself, it needs to recognise that nursing, while playing a significant part in the standard of care, is not the only piece of the puzzle that is not quite fitting correctly.

Jenni Middleton, editor Follow me on Twitter @nursingtimesed


Readers' comments (3)

  • tinkerbell

    the real culprits in all this sadness were given a golden handshake. The executioner always has their face well hidden and they went for the low hanging fruit and demonised nurses as a whole. Wicked thing to do. Seems all the good advice given by Francis has been mostly ignored.

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  • Very true. I'm glad to say that my trust staffing levels are definitely being taken more seriously with an end to unnecessary barriers to bank shifts being authorised and an emphasis on planning for and escalating shortfalls in staffing levels.

    However I'm concerned that while everyone agrees basic care, compassion and communication are important the focus remains on efficiency, patient flow and performance markers. While important these all increase nursing (and medical) workloads and indirectly incentivise paperwork and speedy discharges and transfers over taking time to ensure high quality care and communication with patients and families

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  • Never gonna change, in the long term. Short tem fixes should be the motto of the NHS and the government.

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