The Francis Report

MAIN THEMES

THE HEART OF THE TROUBLE WAS POOR NURSING CARE!

EVIDENCE

This 1,782 page report features 290 recommendations with key themes surrounding the following:

It took many years of campaigning and hurdles before the Francis report was conducted as government ministers did not initially agree to a public inquiry. However the multiple inquiries heard from a wide variety of sources including:

• Personal stories
• PCT
• NHS bodies
• CQC
• CURE
• Local Authorities
• Ministers

• Shared values in which the patient is the priority of everything
• Zero tolerance of substandard care
• Empowering frontline staff with responsibility and freedom to deliver safe care
• Strong and stable cultural leadership and organisational stability
• Comparable data on outcomes
• Transparency and candour throughout

ACCOUNTS

The accounts received by the report highlighted poor basic elements of care and poor quality patient experience: Cases included:

• Falls concealed from relatives
• Patients left in excrement in soiled bed clothes for lengthy periods
• Assistance in feeding not provided for those in need
• Water left out of reach
• Patients not assisted in toileting despite persistent requests
• Poor sanitation in wards and toilets
• Privacy and dignity denied even in death
• Triage in A&E undertaken by untrained staff

"We know only to well what happened at this hospital - what we need to know is why"

GOVERNMENT RESPONSE

Andrew Lansley on announcing the Public Inquiry into Mid Staffs NHS Foundation Trust (Former Health Secretary)

NURSING

REPORT BUILD UP

This report was the fifth and largest investigation into what occurred in the Mid Staffordshire NHS Foundation Trust between 2005 and 2009.

More than £15m of public money has been spent on the public inquiry’s running costs and legal fees.

The report acknowledged "much high-quality, committed and compassionate nursing is carried out day in and day out often with inadequate recognition"

However it states "it is clear that the nursing issues found in Stafford are not confined to that hospital but are found throughout the country"

NURSES & NURSING CARE

NURSING ISSUES

Recommendations

What is it?

• Under staffing and a bullying culture were highlighted as reasons for poor care.
• Skill mix ratio of registered nurse to HCAs dropped as low as 40:60 in some areas
• Staff and patient concerns repeatedly ignored by senior management in favour of balancing the books. More focused on attaining foundation trust status that quality of care. Meeting targets not care.
• The document stated: “The inquiry chairman, Robert Francis QC, concluded that patients were routinely neglected by a trust that was preoccupied with cost cutting, targets and processes and which lost sight of its fundamental responsibility to provide safe care.”

Francis wanted to improve:

• Staffing levels and skill mix
• Protection of whistle blowers
• Training and regulation of healthcare assistants
• Recruitment, training and standards of registered nurses
• The specific training of staff caring for older patients.

The Francis Report was published in February 2013 after multiple concerns were raised including:

• Poor mortality rates compared with other trusts (2007)
• Poor management, appalling conditions and inadequacies across the trust found by the Healthcare commission
• Pressure from patient and relative groups such as CURE

The Francis Report

Hannah BSc (HONS), Katie BA (HONS) & Nicole BEd( HONS)