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4.55pm: The BMA has responded to the NHS staff survey. More action is needed to tackle bullying in the NHS it says. Dr Mark Porter, BMA Council chair said:

“One of the key messages from the Francis report was that NHS staff need to feel able to speak out about patient care. This survey is further evidence of how difficult it is for health professionals to raise concerns. All staff need to know that a zero tolerance policy of bullying exists and they need to see this from the top down.” 

4.23pm: BREAKING NEWS - NHS Commissioning Board chair Malcolm Grant has given his backing to chief executive Sir David Nicholson, amid calls for his resignation. Mr Grant said:

“We have come to a clear view that David Nicholson is the chief executive of the board.

“He is the person whose command of the detail of the NHS and [whose] commitment to its future we believe to be fundamental to the success of the Board.”

4.10pm: More on Labour’s call to reject controversial secondary legislation governing competition and the tendering of NHS services.

Today Mr Burnham claimed Parliament had been misled in the passage of the act as to the extent of competition powers the act would give Monitor, and that the final say would not remain with clinical commissioning groups. If the ‘fatal motion’ is accepted it would see the regulations dropped, Labour said.

3.38pm: Labour has gone for a ‘fatal’ motion in the House of Lords today over the government’s secondary legislation mandating competitive tendering in the NHS.

Andy Burham, Labour’s Shadow Health Secretary said:

“David Cameron promised to protect the NHS, but he has failed. If he gets his way, the NHS will be carved open and exposed to the full force of EU competition law. The genie will be out of the bottle and it will be hard to undo.”

A ‘fatal motion’ forces a debate and vote in March where, if it is passed, the regulations would be fully rejected. Fatal motions are the strongest form of opposition in the House of Lords and are extremely rare. Labour has only chosen to exercise this option twice since the General Election – on tuition fees and legal aid.

2.59pm: Less than two-thirds of staff would be happy to recommend their trust to a friend or relative, the NHS staff survey released today has shown. By contrast, 68 per cent agreed with the statement “my organisation acts on concerns raised by patients”.

2.38pm: Response from Peter Carter, chief executive of the RCN on the NHS 2012 staff survey:

“Shockingly, almost a quarter of nurses said that they have experienced physical violence from patients, relatives or members of the public in the past year.

“Sadly, this survey shows us that things are getting worse, and a picture is being painted of staff under pressure, and patients experiencing frustration and delays.”

2.25pm: 13 chief executives including Catherine Beardshaw at Aintree University Hospital FT, Phil Morley at Hull and East Yorkshire Hospitals, and John Goulston at Croydon Health Services Trust have written to the Times newspaper that “none of us came into the service ‘not to care.”

Their letter to the editor highlights their adoption of Listening into Action. HSJ has previosly covered the workforce programme.

1.33pm Initial results for managers in the NHS Staff Survey for 2012 are a little bleak.

Given that the public places lots of the Mid Staffs blame on managers, the news that only 35 per cent of staff think there is effective communication between senior managers and staff is not encouraging.

Only 26 per cent thought managers actually acted on feedback from staff. On a brighter note , 68 per cent felt their manager “helps them with difficult tasks” and 71 per cent “felt supported in a personal crisis”.

See a full report from HSJ reporter Ben Clover later today.

1.26pm Ok, that concludes proceedings from the NHS Commissioning Board’s meeting. Here’s a quick re-cap for anyone who missed events from Manchester today.

Attended by Robert Francis QC, author of the Mid Staffs report, and addressing the future of NHS chief executive Sir David Nicholson, the meeting was the board’s most closely scrutinised to date.

Board chair Malcolm Grant said he had been “deeply worried” by speculation over Sir David’s future but that the board wanted “very strongly” for him to remain in charge.

Health campaigners, Cure the NHS, who want Sir David Nicholson to resign in the wake of the Mid Stafford Hospital scandal, held a protest outside and some attended an emotionally charged meeting.

Reports say some of the campaigners who attended the meeting walked out after Mr Grant announced the board was backing Sir David.    

Mr Francis:

  • Said there was a need for openness and honesty about the inability to provide services in some areas. The NHS Commissioning Board will be responsible for taking services away if they’re unsafe.
  • Emphasised the need for better quality measurements. Medical professions must devise indicators so patients know if the hospital or consultant they are referred to is any good, he said.
  • Told the meeting being open about bad care will make it easier for the board to make the case that services should be moved from one (unsafe) provider to another.
  • Urged the board to be honest that they know about it, and they’re doing something about it. That will increase confidence in the system.
  • Gave a strong message that commissioner should be close to public and have a strong voice in re-shaping services.
  • Said one role of commissioners should be to ensure choice, so where one provider is unable to deliver safe care, there are other options available.

13.15pm HSJ’s Dave West tweets: “Mental health strategy being developed by @docmdmartin”

12.53pm HSJ’s Dave West tweets:”Francis tells me it’s too early to take a view about government/Nhscb response to his report #nhscb . will comment after gov formal rsponse.”

12.50pm HSJ’s Dave West, who is attending today’s NHS Commissioning Board meeting, tweets: “The NHS Commissioning Board staff have identified concern about lengthy complex recruitment process.

“[Board members say they have] improved diversity but still have work to do. Have started looking at some case studies.

“[Board members says] sheer workload a problem for staff - will it go away or is running cost too low.”

12.28pm HSJ reporter ‏@BenClover tweets “Oh dear, early results from NHS staff survey show ambulance staff feel least valued and least effectively communicated with by managers”

12.13pm Away from the Commissioning Board meeting, health minister Dan Poulter appears to have rejected the Francis Report’s call for nationally recognised minimum nurse staffing levels.Read more here from HSJ reporter Sarah Calkin.

11.34am The NHS Commissioning Board meeting has adjourned for a coffee break. Normal non-Francis business to follow until 1pm or thereabouts.

11.31am Grant’s statement concludes with something along the lines of: Sir David’s grasp of detail in the NHS is a source of strength - we look to him to you to provide the leadership we need as we tackle the massive challenges we now face. The board is clutching him tight.

11.29am Grant: I have discussed the press coverage of Nicholson with Sir David himself, and with the board’s non executive directors.

11.28am David’s current formal position is that his job is split 50/50 between the DH and the NHS Commissioning Board.

11.26am Malcolm Grant is making a statement about chief executive Sir David Nicholson.

11.24am: More from Roger Davidson: “#nhscb CEO Nicholson says NHS needs to understand why things go wrong not just say ‘get it right’”

And: “CEO Nicholson says too many quality accounts have been like “marketing material” - need better info for patients”

11.24am HSJ’s Dave West tweets: “Nicholson - sometimes i and we have said ‘just do it’ about performance rather than reflected on why failing”

11.23am Roger Davidson tweets: “#nhscb CEO Nicholson says he wants patients involved in the development of standards and zero tolerance on problems with safety.”

11.22am Sir David Nicholson is speaking now. Stay tuned for more updates.

11.08am HSJ’s Dave West tweets: “Francis coming over better here than in own report . possibly as not addressing legal change. #nhscb

11.06am Chief nurse Jane Cummings: She founf the Francis report “pretty difficult reading” as a nursing leader, and as a nurse.

10.58am There’s a reconfiguration angle to that too. Mr Francis argues that being open about bad care will make it easier for the board to make the case that services should be moved from one (unsafe) provider to another.

10.55am Francis: “As we sit here, bad things are happening to people in the NHS.” He urges the board to be honest that they know about it, and they’re doing something about it. That will increase confidence in the system. “EUREKA and absolutely”, tweets Roger Davidson.

10.53am Lewisham Council’s cabinet has voted to seek judicial review of the trust special administration process that saw Lewisham Hospital recommended for downgrade, writes HSJ’s London reporter Ben Clover. The south London council will now proceed with the legal action it threatened after Jeremy Hunt said he would accept the special administrator’s recommendation to downgrade services at the site.

10.49am HSJ’s Dave West tweets: “Francis gives strong message on commissioner being close to public and strong voice in reshaping services. @tkelsey1 pleased. #nhscb

10.47am Robert Francis emphasises the need for better quality measurements. Medical professions must devise indicators so patients know if the hospital or consultant they are referred to is any good.

10.42am Further to Antony Sumara’s point, Mr Francis says GPs did not join up the dots between patients, dealing with each problem in isolation.

10.39am Closing his statement, Robert Francis says one role of commissioners should be to ensure choice, so where one provider is unable to deliver safe care, there are other options available. Interesting - but is it practical in rural areas?

10.37am Former Mid Staffordshire turnaround boss Antony Sumara tweets: GP’s who you [the board] are relying on didn’t come out too well in the Stafford Inquiry.”

10.36am Roger Davidson, who has been working on communications for the board, tweets: Robert Francis is setting out a very clear set of messages to the commissioning board - don’t accept poor practice/transparency/culture”

10.33am Francis: There’s a need for opennes and honesty about the inability to provide services in some areas. The NHS Commissioning Board will be responsible for taking services away if they’re unsafe.

10.31am Cris Dowler tweets: “The move to put Mid Staffs in administration will be 1st big test of govt’s#NHS reforms. This is the new system’s answer [to] hospital failure.”

10.30am Here’s a breaking story from senior correspondent Cris Dowler about the news today that Monitor is moving to put Mid Staffordshire into administration.

10.27am The NHS Commissioning webstream is cutting out every few seconds so our coverage could end up being heavily Twitter based. From what we can make out, Robert Francis is outlining how normal people don’t know what a PCT is or does.

10.25am Francis: while PCTs in theory and in law were responsible, in practice they had neither the tools, nor the expertise, nor the bureaucratic inclination to undertake that aspect of their care.

10.24am Robert Francis sitting on Malcolm Grant’s right. Sir David Nicholson on his left. Mr Francis is speaking now.

10.23am In a possible acknowledgement that feelings are runnning high and there’s a risk of heckling from the public gallery, Mr Grant warns: “If there are public interactions meeting will be adjourned.”

10.21am There’s been a confidential meeting to deal with confidential issues such as human resources already this morning, says Mr Grant.

10.18am The NHS Commissioning Board meeting is now live streaming. Chair Malcolm Grant is making some opening remarks about the nature of the meeting. The webstream cut out just as Mr Grant said the meetings are being broadcast via webstream.

10.18am A rare bit of news this morning related to neither the NHS Commissioning Board nor Mid Staffordshire: Thousands of junior doctors have been left in the lurch over their first medical jobs after marking errors in their final exams.

10.15am More on Mid Staffordshire: Monitor says its board decided yesterday,following a recommendation from its appointed contingency planning team. The team was sent into the trust five months ago, and concluded that the troubled trust was neither clinically nor financially sustainable in its current form in the long term. Existing patient services have been given a clean bill of health by the Care Quality Commission, Monitor adds.

Chief executive David Bennett said today: “We are now consulting on whether to appoint trust special administrators with the expertise to reorganise services in a way which is clinically robust and sustainable. Their priority will be to make sure that patients can continue to access the services that they need and they will work with the local community to do this.

“Taking into account the consultation process, it would be several weeks before trust special administrators were in place. In the meantime the trust board will continue to ensure the current range of services are delivered for patients and Trust Special Administrators would then continue that responsibility.”

10.07am Monitor has just announced that it is beginning the procedure for putting Mid Staffordshire Foundation Trust into special administration. More on this soon.

10.06am The Daily Mail, which has been campaigning for Sir David Nicholson to resign as chief of the NHS Commissioning Board, has another front page story at about the NHS this morning.

The story mostly focuses on yesterday’s news that the chief executive of Bolton Foundation Trust has “stepped aside” while its mortality rate coding is under investigation. “NHS hit by new hospital deaths cover-up,” the Mail says, linking the story to today’s “showdown” NHS Commissioning Board meeting.

In an interesting style development, the paper’s strapline refers to Sir David as “The Man With No Shame”, with capital letters.

10.00am Tim Kelsey, the board’s director for patients and information, tweets that this morning, “[I] am proposing new civil society assembly and new patient and public voice data service for NHS.”

9.59am NHS Commissioning Board chief executive Sir David Nicholson faces a silent protest outside today’s board meeting. The protest has been organised by Cure the NHS, who are calling for Sir David to resign over the Mid Staffordshire scandal. Sir David was in charge of the local strategic health authority overseeing Mid Staffordshire at the time of catastrophic failures in care.

The protest is planned to last for the duration of the three-hour meeting.

9.54am HSJ’s chief reporter and acting news editor Dave West is on his way to Manchester for the commissioning board meeting right now. He’s been looking through the board papers on the way, and tweets: “NHS CB staff end state now 5,984… Includes ones they forgot but not yet ones they forgot they forgot.” It’s not yet clear the extent to which that last bit is a joke - hopefully it will become clear during the meeting.

9.50am Today’s NHS Commissioning Board meeting is expected to run from 10.15am to 1pm. It will be live streamed here.

9.49am You can download the commissioning board’s agenda papers from their website here. You’ll notice that the Francis report is top of the agenda.

9.44am: Good morning, and apologies for the slightly later than usual start this morning. Today Robert Francis QC will appear at the NHS Commissioning Board’s meeting in public to discuss his report into failings in care at Mid Staffordshire Foundation Trust.