What changes have you seen as a result of the Francis report? This snap survey will be open until 7pm on Friday 7 February
4:00pm On the anniversary of the Francis report, Robert Francis QC said he was generally “very encouraged by the response”, but he warned “the picture, although encouraging, is not entirely reassuring”.
Speaking at Nuffield Trust event earlier today, Francis said: “I sense there remain those who reassure themselves that a Stafford could not happen on their patch.
“I believe such a belief is seriously mistaken, even in the many parts of the health service where excellent care is provided. It must be remembered that much good care was provided in Stafford as well.”
He said: “Drawing attention to unacceptable care is not an attack on those who strive to provide excellence.”
Francis pointed to the tribunal that last week found South Devon Healthcare Foundation Trust attempted to cover up a report that contained accusations of nepotism against its chief executive, Paul Vasco-Knight. He said it is “is important that no tolerance is afforded to oppressive managerial behaviour… which victimises staff who raise honestly held concerns”.
However, he praised developments such as health secretary Jeremy Hunt’s promotion of named doctors and nurses for individual patients, greater openness in the CQC, the development of individual performance measures for a greater number of specialities, and “on a personal level” the OBE awarded to Stafford whistle-blower Helene Donnelly.
3:30pm Figures show that NHS care has changed for the better just one year on from the Francis Inquiry into Mid Staffordshire, Health Secretary Jeremy Hunt said at a conference in London.
He spoke about the ‘Francis Effect’, with improvements including failing hospitals being put on the road to recovery, more nurses on the wards, more doctors, and feedback direct from patients changing the way hospitals work.
Speaking about the Francis Inquiry anniversary Jeremy Hunt said:
“Most weeks I join staff in different parts of the country on a shift, and I have seen first-hand how hospitals are using the Francis report as a catalyst to improve care.
“Twelve months on, we cannot expect to have solved everything or to have completely transformed the culture of the country’s largest and finest institution. But we have seen a real shift in priorities - new inspections, more nurses and a stronger voice for patients, with compassionate care starting to replace tick-box targets as the major focus on boards and wards.
“Our goal is safe and compassionate care as the hallmark of every hospital and experience of every single patient and family. As the NHS starts to cross this Rubicon, we must pay tribute to the hard work of NHS staff as well as the whistleblowers and patients’ champions who refused to be silenced. It is their efforts that have made the Francis Inquiry a turning point in NHS history.”
The Health Secretary highlighted a number of changes since the Francis Inquiry, including:
An extra 2,400 hospital nurses hired since the Francis report, with over 3,300 more nurses working on NHS hospital wards and 6,000 more clinical staff overall since May 2010
He himself has done shifts on the frontline most weeks, including cleaning beds, working as a porter and serving tea. 140 Department of Health staff have spent at least a week working on the frontline of the NHS, totalling around 1,000 days on the frontline
14 hospitals in special measures are being turned round, with 650 extra nurses and nursing assistants hired in those hospitals, strong leaders installed, and 49 board level managers replaced
Nearly 40 per cent of hospitals now have the names of a senior responsible doctor above patients’ beds
165 nursing students piloting a radical new training approach working as healthcare assistants before their nurse training
Nearly 1.6 million patients have given direct feedback on what they thought about their treatment through the Friends and Family Test
84 patient and public representatives have taken part in CQC inspections so far. In July 2013, 2,446 patients offered to take part in an inspection
The government will publish a progress report on Francis in November this year.
2:40pm The Wells Suite, situated within the Tunbridge Wells Hospital at Pembury in Kent, is the first to launch a new, state-of-the-art outpatient hysteroscopy service, including ‘see and treat’ facilities, to women in Kent.
Its new one-stop service will offer referred patients confidential specialist advice and care, flexible appointment times (including after work), and a female consultant gynaecologist, if requested.
At its launch event held today (5th February 2014), primary care health professionals were invited to a tour of the new facilities and presentations were given by the resident consultants on the gynaecological services that can be treated at The Wells Suite.
All common gynaecological disorders can be addressed, including:
- Menstrual problems
- Pelvic pain
- Vulval pain
- Menopause and HRT
- Endocrine disorders including PCOS and PMS
- Prolapse and urinary incontinence
Ms Anne Henderson, a consultant gynaecologist at Maidstone and Tunbridge Wells NHS Trust, said, “I am delighted to open the new gynaecology service being offered at The Wells Suite and am looking forward to treating women in Kent here. The income generated from The Wells Suite makes a considerable contribution to the running costs of Maidstone and Tunbridge Wells NHS Trust and every penny of profit is invested into our NHS Trust for the benefit of all patients and staff.
1:18pm HSJ reporter Judith Welikala tweets from the Nuffield Trust: “Francis says the time for discussion about what needs to be done has surely passed and now is the time to implement it.”
12:50pm Catherine Foot, asistant director for policy at the King’s Fund has written a blog exploring broad developments across the system, one year since Robert Francis published his second report. Read it here.
12:35pm It is one year since Robert Francis QC published the findings from his inquiry into care failures at Mid Staffordshire Foundation Trust. His report contained 290 recommendations with implications for every level of the health service.
We would like you to tell us: What changes have you seen as a result of the Francis report?
This snap survey will be open until 7pm on Friday 7 February. A selection of responses will be published on hsj.co.uk next week.
The survey will be facilitated by a secure, easy to use website. You are invited to submit your ideas, read and comment on the ideas of others and vote for those you like the best - all anonymously.
Join the campaign by visiting http://hsj.clevertogether.com/home/sign_up and enter your email address. You will then be sent a message with your password. Once you have logged in you will be able to invite colleagues to take part
12:10pm Several councils are planning to pool their entire adult care budget with the NHS in one of the biggest boosts to the integration of care between the two sectors to date, it has emerged.
The plans would result in the value of the government’s better care fund, designed to boost care integration, rising by up to 849 per cent in individual areas.
11.38am HSJ reporter Judith Welikala, tweeting from the Nuffield Trust’s conference on their research one year on from the Francis Report, reports: “Dr Patrick Cadigan [of Heart of England FT] says he worries about the relationship between trusts and regulators and they haven’t developed partnership over quality.”
11:30am The health scretary has warned that patients should expect more hospitals to be put in “special measures”.
At present 14 NHS trusts are operating under the regime, which is put into place when hospital inspectors identify major failings, and Jeremy Hunt has said that the public should expect more trusts to follow suit.
For more details, and to read the full story - click here.
10.43am South Devon Healthcare Foundation Trust has launched an internal investigation into its chief executive Paula Vasco-Knight after a tribunal last week found the trust covered up “nepotism” claims against her.
Two former employees raised concerns after the boyfriend of the daughter of Dr Vasco-Knight - who was also until last week NHS England’s national lead for equality and diversity - was given a job at her trust.
Subsequently the two former employees, Clare Sardari and Penelope Gates, were told they would not be able to remain working across the two trusts because it was claimed they had broken trust policy by making “false accusations”.
There could be “potential rationing of high-value treatments” without such charges, they argue.
NHS hospital cancer specialist, Ajay Aggarwal, said: “New approaches to paying for cancer care need to be found.”
Dr Aggarwal and Richard Sullivan, director of the Institute of Cancer Policy at King’s College London, have authored a research paper into healthcare system sustainability.
10.35am From the Nuffield conference on one year since Francis where our reporter Judith Welikala is tweeting - “Dorrell says every patient complaint is a learning experience and shouldn’t be treated as a possible legal claim”
10.34am Our reporter Judith Welikala is live tweeting from the Nuffield Trust’s conference today on their research one year on from the Francis Report. Follow her @judithwelikala for updates.
The “bionic hand” could lead to a new generation of prosthetics which can provide real-time, tactile information about the surrounding environment.
The think tank warned that spending per patient is on course to fall by more than 9 per cent over a decade despite the “extensive and generous” ring-fenced health service budget.
Britain’s poopulation is set to grow by 3.5m between 2010 and 2018 with the number of over 65s growing by 2m.
10.15am A year since the Francis report, hospitals are working hard to ensure the toxic culture of Mid Staffs is a thing of the past, says Judith Smith from the Nuffield Trust.
Professor David Cunningham of the Royal Marsden hospital said the drug was a “significant step forward” and should be “available for patients with this cancer”.
10.07am The Telegraph reports that MPs are calling for a national investigation into whether cancer patients have been denied care, following the situation in Hertfordshire where 800 patients were affected by glitches in the recording system.
Six local MPs have written to Jeremy Hunt calling for an inquiry to establish whether other hospitals have made the same mistake.
10.01am The Times also reports that GPs should not neglect people with anxiety problemsaccording to NICE.
One in 20 people has an anxiety disorder at any one time and GPs should get better at offering talking therapy and self-help advice rather than resorting to prescribing drugs, says NICE.
9.55am The Times reports that a repeat of the Stafford Hospital scandal is still possible and it is “dangerous” for staff to think otherwise, according to Robert Francis QC.
Mr Francis warns that regulators are still “bullying” hospitals to hit financial targets at the expense of patient care.
9.43am The Department of Health has announced that it will be mandatory from April for all acute hospitals to provide information on patients who have undergone female genital mutilation.
This will be recorded centrally, helping to provide more information on the incidence and prevalence of FGM than ever before.
In addition, following the Home Office’s successful bid for funding from the European Commission, a new £100,000 FGM Community Engagement Initiative launches today. Charities can bid for up to £10,000 to carry out community engagement work aimed at raising awareness of FGM.
The government has also appointed a consortium of leading anti-FGM campaigners to deliver a global campaign to end FGM.
Today, government ministers met with charities and stakeholders at a roundtable to discuss future work to end FGM and sign a declaration of their ongoing commitment.
From April this year hospitals will be required to record:
- if a patient has had FGM
- if there is a family history of FGM
- if an FGM-related procedure has been carried out on a women - (deinfibulation)
By September this year, all acute hospitals must report this data centrally to the Department of Health on a monthly basis. This is the first stage of a wider ranging programme of work in development to improve the way in which the NHS will respond to the health needs of girls and women who have suffered FGM and actively support prevention.
Public health minister Jane Ellison said: “Female Genital Mutilation is an abhorrent practice that has no place in this – or any other – society.
“In order to combat it and ensure we can care properly for the girls and women who have undergone mutilation we need to build a more accurate nationwide picture of the challenge. This is the first step towards doing that.”
7.00am Good morning and welcome to HSJ Live. Following on from our analysis yesterday about the impact of the Francis report, the Nuffield Trust has published research which it says shows financial pressures and a complex regulatory environment are getting in the way of creating the kind of patient-centred culture recommended by Robert Francis QC.
However, the health think tank says its interviews of NHS staff show the Mid-Staffordshire inquiry has added impetus to efforts to prioritise quality of care.
Commenting on the Nuffield Trust’s research, Robert Francis QC, said:
“It is reassuring to see that in large part the respondents to this research appear to have embraced the need to learn from the two inquiries into Stafford and the alarming events which they described. In particular there appears to be general acceptance that quality needs to be given a much greater priority.
“It is concerning, however, that some respondents reported that national bodies have persisted in some of the behaviours towards hospitals that evidently contributed to the problems identified by the two inquiries. If true, it would suggest that the lack of coordination and elements of the system-based culture so evident in the regulation and oversight of Mid Staffordshire have persisted in spite of the assertions to the contrary by the regulators.
“It is vital that national bodies exemplify in their own practice the change of cultural values which all seem to agree is needed in the NHS.”