Robert Francis QC has expressed surprise at the decision by NHS England and Monitor to use his report into failures at Mid Staffordshire Foundation Trust as justification for higher funding cuts to mental health.

Mr Francis told HSJ the recommendations he made to improve standards of care in the NHS were “just as applicable” to the non-acute sector, adding he would be “very concerned” if as a result mental health was given “even less priority” than it currently is.

His intervention brings further embarrassment for NHS England, which has repeatedly claimed the costs of implementing recommendations from the Francis report as justification for their decision to apply higher efficiency requirements to non-acute providers.

Health minister Norman Lamb has said the decision was “flawed, not based on evidence and cannot be defended”, while leaders from across mental health have accused NHS England and Monitor, which share joint responsibility for the payment system, of “institutional bias”.

Guidance on the application of the tariff in 2014-15 said commissioners should apply a 1.8 per cent cut for non-acute providers versus a lower 1.5 per cent cut for acute trusts.

Mr Francis told HSJ: “I am surprised that it should be thought that any costs associated with the implementation of my report, and the Keogh review, should be limited to the acute sector.

“While my report arose out of a serious deficiency and appalling care delivered in the acute sector, it is clear to me that the requirements for maintaining and protecting standards that have arisen out of this are likely to be applicable to the non-acute sector, particularly in the field of mental health, as any other.

“I would be very concerned if mental health as a result was given even less priority than currently.”

Mental Health Network chief executive Stephen Dalton said it was “reassuring and welcome that someone of the stature of Robert Francis is expressing concern about the institutional bias shown to mental health


“It’s long overdue that NHS England show some leadership instead of putting their energy into spinning excuses for their mistake. This is all about doing what’s right for service users and an early opportunity for [new NHS England chief executive] Simon Stevens to intervene,” he added.

An NHS England spokesperson said: “The decision last year to put additional resources into the tariff for acute care for 2014-15 was based on an assessment that acute providers are facing particular pressures in the coming year.

“A wide range of factors were taken into consideration. We are working closely with mental health providers to understand their cost pressures for future years.”