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One year on from hard truths

A year on from the government response to the Francis report here is a summary of what has happened and the work NHS Confederation and NHS Employers has done to support the improvement of care for patients

NHS Confederation

on 11 February 2015

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Transcript of One year on from hard truths

Keogh review
Professor Sir Bruce Keogh's review into the quality of care and treatment provided by 14 hospital trusts in England looked at the mortality rates at 14 acute trusts identified as having higher rates than expected over the past two years.
Bureaucracy review
In March 2013, the co-chairs of the Children and Young People’s Health Outcomes Forum wrote to the health secretary to offer the forum’s assistance in addressing the broad issues raised in the Francis report as they relate to children and young people.

The forum’s report concluded that, although Francis focused primarily on NHS hospitals, the core messages are applicable to all staff and organisations working across the health and care system.

It called for a universal children and young people-friendly culture and made a series of recommendations in relation to the NHS Constitution, leadership, the inclusion of children and young people in patient and public involvement, training, transparency, safety and outcome indicators.

Children and Young People’s Outcomes Forum Review
Hard truths: one year on
Working with member to improve standards
We brought together representatives from the 14 trusts inspected by Sir Bruce Keogh's review team to share their experiences and use this learning to help improve the care delivered to patients
We are ensuring members are kept up to date on changes to the new CQC inspection regime through events and regular communications, enabling members to share their experiences of inspection processes and feeding this information back to the CQC, with a view to making the process as effective as possible.
We responded to the CQC's consultation on the guidance for NHS bodies on the fit and proper person requirements (FPPR) for directors and the duty of candour in September, and provided senior leaders with a platform to give their views directly to the CQC on changes that will impact organisations.
Clwyd-Hart review
Putting patients back in the picture
examined how complaints about care in NHS hospitals are listened to and
acted on by hospitals.

What the NHS Confederation and NHS Employers have been doing
Hard truths
On 19 November 2013, the Government published its full response to the Francis report, addressing each of Robert Francis's 290 recommendations. Key developments:
regular publication of patient safety data
statutory duty of candour on organisations and professional duty on individuals
greater senior involvement in complaints handling
guidance and tools for setting staffing levels and regular publication of actual levels
fit and proper persons test for Board members and greater performance management of very senior manager
a new offence of wilful neglect, applicable to individuals and to organisations
a 'Clinical Bureaucracy Index' for trusts and Concordat between national bodies to reduce bureaucracy.

The d to 'Hard truths': independent reviews
Children and young People's Health Outcomes Forum review (23 October 2013)
Cavendish review (10 July 2013)
Keogh review (16 July 2013)
Berwick review (6 August 2013)
Clwyd-Hart review (28 October 2013)
Bureaucracy review (15 November 2013)
Working with employers to improve nursing
Coming up....
Working with members to improve the complaints system
NHS Confederation and NHS Employers submitted a consultation response to Sir Robert Francis QC's independent review into raising concerns in the NHS
With the Foundation Trust Network, we held a roundtable event with Sir Robert. The event was attended by senior leaders from across the NHS and fed into the 'Freedom to Speak Up' review.
NHS Employers and the NHS Confederation gave written and oral evidence to the health select committee on their enquiry into complaints and raising concerns
producing practical tools for members to navigate their way through the new fit and proper person requirements and the duty of candour regulations.
delivering a joint event with the Foundation Trust Network on quality.
our annual conference in June 2015 will have a key focus on quality of care for patients and improving transparency. Find out more at http://www.nhsconfed.org/2015
holding a series of webinars looking at the inspection process for ambulance Trusts
Berwick review
Professor Don Berwick's review highlighted the main problems affecting patient safety in the NHS and made a number of recommendations to address them, including:
Download the report and find out more at

Working with members to balance quality and finance
On 6 February 2013, Sir Robert Francis QC published a seminal report for the NHS, following a second public inquiry into serious failings in care at Mid Staffordshire NHS Foundation Trust.
In the wake of the report, the Government commissioned six independent reviews to consider several of the key issues identified by the inquiry.

The reviews’ findings helped to inform the Government’s full response to the Francis report, which was published on 19 November 2013.

The NHS Confederation and NHS Employers organisation have been supporting members to implement the changes ushered in by the landmark report.

Cavendish review
Camilla Cavendish conducted a review into healthcare assistants (HCAs) and support workers in the NHS and social care.
The report put forward a package of recommendations for how training for how HCAs can be improved to ensure they provide care to the highest standard.
adopting a culture of learning
ensuring adequate staffing levels
creating new criminal offenses for recklessness or mistreatment.
Both the NHS Confederation and NHS Employers contributed pledges as part of the report.
The Secretary of State for Health commissioned the NHS Confederation to complete a review of the bureaucratic burdens on providers of NHS care from national bodies.

Our report
Challenging bureaucracy
sets out what we found and what actions should be taken to free the NHS from unnecessary bureaucracy.
Find out more by visiting:
Decisions of Value is a project led by the Academy of Medical Royal Colleges and the NHS Confederation that spent six months studying what influences the decisions made in the NHS. It brings together a large amount of research to show how decisions impact on the value delivered and how this extends beyond Whitehall to the front line.
The Secretary of State referenced the decisions of value work in a speech made at Birmingham Children's Hospital in October 2014
"We have recently seen powerful evidence to support this from the joint work by the Academy of Medical Royal Colleges and the NHS Confederation . They explore what they call 'decisions of value' and conclude that good relationships between clinicians and managers is critical in securing value for patients "
Jeremy Hunt Secretary of State for Health
Find out more at http://www.nhsconfed.org/value
NHS Employers has produced a range of materials for employers to engage with staff about raising concerns Find out more at http:www.nhsemployers.org/raisingconcerns
The NHS Employers organisation has been advising and representing employers on various strands of work stemming from the Cavendish review.
Find out more at:

NHS Employers is helping the Nursing and Midwifery Council devise a revalidation model for nurses and midwives
NHS Employers is leading on the delivery of the work to support Action Area 6 (supporting positive staff experience) of NHS England’s Compassion in Practice programme, which presents a new vision and strategy for nurses, midwives and care givers in England.
To find out more visit http://www.nhsemployers.org
The NHS Confederation will be working with the Parliamentary Health Service Ombudsman in the new year to consider how we can end the blame culture in the NHS.
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