A year on from publication of the Francis report, The Nuffield Trust has published a report on how NHS trusts have responded to Francis’ shocking findings and wide-ranging recommendations. So how much progress has been made?
Well, it’s something of a mixed bag, but Rome wasn’t built in a day. On the plus side, four in five of trusts responding to the Nuffield study said they were taking new action in response to the report, while hospital leaders said they gave greater priority to patient safety and care, and the organisational culture that drives quality.
The report also reveals that nursing is receiving a significant degree of attention, particularly over staffing levels, the role of ward managers, and ensuring fundamental standards of care. Trusts are also working to improve staff engagement and the way they handle complaints.
Less encouragingly, trusts reported that inspections by external regulatory bodies could be better coordinated to make data collection less onerous, and that there remains a profound tension between the competing priorities of care quality and financial performance.
But perhaps the report’s most worrying finding is that many staff still don’t feel confident about raising concerns, despite trusts working hard to create open and transparent cultures, and reviewing their whistleblowing policies.
Culture change takes time to embed, particularly in large organisations. So it’s hardly surprising if staff, having seen the appalling treatment meted out to many whistleblowers in recent years, aren’t immediately won over by these efforts. That’s one of the reasons we set up our Speak Out Safely campaign – it enables trusts to make a very public commitment to protecting staff who raise concerns, and gives staff a set of principles to hold their employers to.
Signing up to NT SOS is simple, and it sends a powerful message to staff, patients and families that the organisation wants to learn from mistakes rather than cover them up. However, to date, only 76 trusts in England have signed up. What kind of message does that send to staff in the rest of the NHS who may want to raise a concern?
- If your trust hasn’t signed up to NT SOS yet, you can download a letter inviting your CEO to consider it