Robert Francis QC has called for a further deceleration of the drive for all NHS providers to become foundation trusts, in order to ensure trusts completing the process are safe.
He made the call in an interview with HSJ last week, following publication of his inquiry’s report on the care quality scandal at Mid Staffordshire Foundation Trust.
The inquiry had found that, in the case of Mid Staffordshire, “pressure on the system” caused by the drive for universal FT status had meant that “considerable strains were placed on an organisation in financial difficulty to meet required financial targets”, and that “inadequate consideration was given to the risks such strains posed on the standard of service”.
Its report warned: “There is a danger of history repeating itself. It is not possible to be sure that other Staffords do not exist within the system. The policy of converting all trusts to FTs persists, as does a timetable for achieving this.”
Following publication, prime minister David Cameron was asked if he had made any “reassessment” of the current timetable for remaining NHS trusts to become foundation trusts.
He replied: “The problem is not with creating foundation trusts, but arises if the move to create them means that other things that matter more than trust status — such as patient care — are pushed to one side.
“We must all learn the lesson and ensure that for the next round of trust creation, they must not be rushed and they must happen only when they are ready and on the basis that patient care comes first.”
Mr Francis told HSJ that the prime minister’s comments “would suggest a slowing down of the process”, adding: “I would support that.”
David Bennett, chief executive of foundation trust regulator Monitor, noted that the government had already relaxed its 2014 deadline for an all-FT NHS, and said he supported that decision.
He added: “What I absolutely accept is it would be possible to push too hard and too fast. I hope that our assessment process is now sufficiently robust – working with the [Care Quality Commission] – that we wouldn’t authorise them if they’d been pushed too hard and too fast, but it’s still not in the interests of the patients they’re serving if that were to happen.”
He said the timetable pursued by the NHS Trust Development Authority – which is responsible for getting the remaining NHS trusts to FT status – should be one that “delivers high quality trusts delivering high quality care on a sustainable basis”.
A spokesman for the authority said: “We are absolutely clear that our primary focus is to support NHS trusts to deliver high quality and sustainable services for the patients and communities they serve, with achieving foundation trust status as a secondary by-product of that.”