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Government publishes ‘blueprint for trustworthy’ NHS

Secretary of State for Health Jeremy Hunt has this week outlined the Government’s response to the Francis Report into the deaths at Stafford Hospital, saying that the NHS needs to undergo a “profound transformation” to create an open, honest and learning culture that will give patients “the best and safest care…in the world”.
The Government has agreed to accept all but nine of the original 290 recommendations made by Robert Francis QC in his report, including

  • Getting hospitals to publish details of whether they have enough nurses on wards, with the numbers to be put on a new national safety website
  • Hospitals will have to produce quarterly reports on how they are handling complaints and clearly set out how patients can raise them.
  • A legal duty of candour on organisations to be open and honest about mistakes.
  • A criminal offence of willful neglect to hold staff to account.
  • A “fit and proper person’s test” so managers who have failed in past will be barred from taking up posts.
  • Care certificates to ensure healthcare assistants and social care workers have the right skills and training.
  • Every patient should have the names of a responsible consultant and nurse listed above their bed.

The nine recommendations that the Government have chosen not to take forward include the call for the regulators Monitor and the Care Quality Commission to be merged, although the decision made recently to grant both organisations extra responsibilities made that unlikely.
But of the 281 accepted recommendations, one in four of them has not been met fully, for example the inquiry called for a system of registration for healthcare assistants, but the care certificate falls short of that. The inquiry also originally called for the duty of candour to apply to individuals, not just organisations.
However, Robert Francis QC, the chair of the Inquiry, has said he is happy, describing the Government’s response as a “comprehensible collection of measures”.
The Francis Inquiry, which was published at the start of February, was set up to tackle the wider cultural problems in the NHS after the discovery of widespread abuse and neglect at Stafford Hospital. The inquiry accused the NHS of putting corporate self-interest ahead of patients and concluded that the failings went from the top to the bottom of the system.
The Patients Association welcomes the commitment by the Secretary for State for Health to adopt most of the recommendations of the Francis Report. However, the organisation does warn that some vital recommendations have not being accepted and that patient care should suffer as a result.
In particular, the failure to adopt recommendations around the registration of Healthcare Assistants, has led to concerns that the safety of patients will be compromised. The organisation does believe however that the adoption of most of the recommendations will lead to considerable advances in patient safety. In particular, it strongly supports moves to provide more information on staffing numbers in hospitals, safety information on hospitals and closer monitoring of the complaints system.
Speaking about today’s announcement, Katherine Murphy, Chief Executive of the Patients Association, has said:
“We have said on many occasions in the past that the Francis recommendations represent a blueprint for an NHS that treats people in a safe environment, with dignity and respect.
Whilst we should recognise the considerable step forward taken today, we need to remember that it simply isn’t enough to commit to implementing the reforms. In relation to staffing numbers, for example, it is about getting the right staff as well as simply ensuring that the ratio is correct. There is also real concern about where the nurses need to meet the ratio will be found.
In relation to complaints, we need to see tough action taken against those trusts that are consistently underperforming.
For many years the Patients Association has raised concerns about care in hospital, especially for the elderly, and has published a number of reports on the subject. It is therefore extremely welcome that the Government will make it a criminal offence to willfully neglect patients, all of whom will have had complete faith in those that mistreated them.
We will be monitoring the implementation of these proposals closely, but we really do believe that today is a move towards restoring the faith patients have in the NHS.”

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