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Francis Report - Opinion

What are the signs the NHS is failing?

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The NHS isn’t necessarily failing as an institution, but there are clear examples of where we have failed to deliver high-quality care consistently and responsively to our patients

In my career I have worked with inspiring, dedicated and committed individuals who deliver exceptional care to a high-standard.

As a leader of nurses and midwives, my test of quality is my own family - if the care that I and my nurses and midwives provide is good enough for them then it will be good enough for my patients.

There are, however, a number of examples where we (and by “we” I mean organisations, both the professions and individuals) have clearly failed to deliver high-quality care and treatment and quite frankly let both our patients and ourselves down. Recent examples include:

  • The failure to care for people with learning disabilities at Winterbourne view;
  • The failure to provide adequate standards of care on some wards at Stafford Hospital  between 2005 and 2009;
  • Evidence from the Care Quality Commission, the Patients Association and the Parliamentary and Health Service Ombudsman - highlighting the individual impact and distress that failures in care can cause both patients and their families.

Not only do these examples show where we have failed to listen to patients and staff, but also where we lack the courage to speak up for our patients, and, ultimately, have lost sight of the principle of being a public servant - to serve.

However, it is important to note that we all face the challenge of poor-quality care. This isn’t about high performing versus low performing organisations, nor is it driven by the type of organisation – whether a hospital or community setting, public or private, we all face the same kind of issues.

In all settings, staff are being asked to deliver more with less and provide high-quality care within an NHS that is undergoing significant structural change.

It is important to learn from such failures to prevent them reoccurring, but also important to discuss, commend and replicate the many examples of good practice to reinforce the standards of care that the majority of those working in the NHS are committed to providing.

Steve Hams is Interim Director of Nursing at Cambridge University Hospitals Foundation Trust

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