Responding To The Francis Report: Getting Back To Basics

The Francis report on Mid Staffordshire NHS Foundation Trust published last week contained close to 300 recommendations.  Since then there has been lots of blogs, articles and discussions about what is needed to move forward.

Suggestions have been made that management needs to be enhanced across the whole of the NHS in light of what was found.

Others are saying that top leadership needs to be medically trained to take up more senior roles.

There are calls to beef up the inspection arrangements across the board.

While there is merit in all these points, in reality all of these initiatives are going to take time to establish.

While these initiatives are discussed, debated, tested, adapted and implemented it is business as usual.  Patients are still going to turn up for outpatient appointments, for surgery and are going to be admitted from A&E.

And if you are a patient or a relative, particularly of someone elderly what is going to be the big questions on your mind?

Am I or if it is a relative is my mother, father, grandmother, grandfather going to be properly looked after.  Is someone going to make sure they eat, get a response if they call a nurse and are treated with dignity and respect?

If a Ward Manager or Senior Nurse has concerns about the levels of staffing to look after the intensity of patients on their ward, will they get the support to get in the additional resource they need to provide good care or will they be ignored?

Are the senior people in the hospital tuned into what is actually happening on the ground and making sure that they are doing everything they can to support the people on the ground?

Not difficult or complex questions.  At the same time answering these and communicating with patients, service users and relatives on these questions can go a long way to restoring confidence.

So what in practical terms can be done to provide that confidence?

Have the Nursing and Medical Directors going round the hospital regularly to check in with people on wards what the situation is, what challenges they have and then help them to solve them.

Agree that as a matter of course if concerns are raised about the level of resources they will be considered by someone who has the professional expertise to review and make a professional judgement on the concern.

Re-focus everyone whatever the role they do that the primary focus has to be on the patient.  That does not need to mean that people are given carte blanche to spend resources without thinking and in truth my experience is that people in the NHS generally are very careful about how they use resources.

Make sure that across the health economy people are working collaboratively on this rather than each organisation working in silos.  This is not a time for them and us but a time for working together in the interests of patients and restoring the confidence in the service.

In truth while there will in time be changes that will take effect across the NHS, there are plenty of actions that can be taken at organisational and health economy level to restore confidence.

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