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The Board was clearly weak & / or misguided but it was doctors & nurses on the front line that did not do the right thing for the Patients who were harmed or died.
Rightly, Directors should be held to account & if they are found to be "unfit" then they should be sacked & disqualified from Executive roles in the NHS.
Similarly, we expect Nurses to be caring & doctors to be experts, both acting in the best interests of their Patients. And, bad ones need to be routed out.
If Managers are guilty of intimidating clinicians & of preventing them from doing their jobs properly then we have got to wonder if the Royal Colleges & BMA could not have got involved & done something to protect their members & their patients & also deal with any poor performance too.
To my mind, the Francis Report contains far too many recommendations. I would rather it focused on just a few big things that have GOT to be done.
For example:
1. Every person (back office or front line or otherwise) in the DH & NHS must have a written job specification that clearly describes how their responsibilities & personal objectives are designed to directly or indirectly improve Patient Health & Care.
2. The right for any member of a hospital's staff / or Patient [advocate] to access in confidence designated Public Governors who must then take up issues they think might be prejudicing Patient Care with the Chairman & get them resolved to their satisfaction.
3. Professional bodies to ensure that their members are held to account & proper system of consequences applied.
4. Misleading or deceiving a Regulator to be a criminal offence.
5. Prominent publication of key measures of Quality with full and frank explanations + Quality Statement in the Annual Accounts by both the Chairman & the Chief Executive. Any misrepresentation or neglectful statements being a criminal offence.
6. Every Project Initiation Document concerned with sigificant Cost Improvement / Process Change / Target Achievement to include an assessment of how it will most likely impact the quality / timeliness of Patient Care.
7. Vicarious Liability of Chief Nurse & Medical Director