This page brings together key information on:
The Francis Report
Following an extensive inquiry into failings at Mid-Staffordshire NHS Foundation Trust, Robert Francis QC published his final report on 6 February 2013.
It told a story of appalling suffering of many patients within a culture of secrecy and defensiveness. The inquiry highlighted a whole system failure. A system which should have had checks and balances in place, and working, to ensure that patients were treated with dignity, and suffered no harm.
The 1,782 page report had 290 recommendations with major implications for all levels of the health service across England. It called for a whole service, patient centred focus. The detailed recommendations did not call for a reorganisation of the system, but for a re-emphasis on what is important, to ensure that this does not happen again.
Read the full Francis report.
Hard Truths: The Government response to Francis
On 19 November 2013, the Secretary of State for Health issued his response to the Francis report, in which the Government undertook to fully implement 204 of the 290 recommendations.
Some of the Government's pledges which will have workforce implications, include:
- Safe staffing: from April 2014, all hospitals will publish staffing levels on a ward-by-ward basis together with the percentage of shifts meeting safe staffing guidelines. This will be mandatory and will be done on a monthly basis. By the end of next year this will be done using models approved independently by NICE. Access the new National Quality Board (NQB) guidance on safer staffing.
- A new national patient safety programme across England will spread best practice and build safety skills across the country. NHS England will start the programme in April 2014.
- 5000 patient safety fellows will be trained and appointed by NHS England within five years, to be champions, experts, leaders and motivators in patient safety.
- Complaints reporting and better complaints information: Trusts will report quarterly on complaints data and lessons learned and the Health Service Ombudsman will increase significantly the number of cases she considers. In addition, all hospitals will be required to set out clearly how patients and their families can raise concerns or complain, with independent support available from their Healthwatch or alternative organisations.
- A new criminal offence for wilful neglect: the Government will legislate at the earliest available opportunity to make it an offence to wilfully neglect patients - so that organisations and staff, whether managers or clinicians, responsible for the very worst failures in care are held accountable.
- A new Fit and Proper Person's Test which will enable the Care Quality Commission to bar unsuitable senior managers who have failed in the past from taking up individual posts elsewhere in the system.
- A new Care Certificate to ensure that Healthcare Assistants and Social Care Support Workers have the fundamental training and skills needed to give good personal care to patients and service users. The Chief Inspectors will ensure that employers are using the Disclosure and Barring Service to prevent unsuitable staff from being re-employed elsewhere.
- Every hospital patient should have the names of a responsible consultant and nurse above their bed. And as announced last week as part of the agreement with GPs, starting with over-75s from next April, there will be a named accountable clinician for out-of-hospital care for all vulnerable older people.
Download the Government's full response, Hard Truths: The journey to putting patients first, and its response to each recommendation.
Access DH information about the response, helpfully separated into themes.
Subsequent reports and reviews
Following publication of the Francis report, the Government commissioned a number of national reviews to explore in detail what needs to happen to help organisations improve the quality of patient care across the NHS.
The reports listed below, and their authors are acknowledged in the Government response Hard Truths: The journey to putting patients first:
How NHS Employers is supporting you
We have been working closely with employers since the publication of the Francis report on its key workforce implications. You have been doing a lot to improve patient care since the first Francis report was published. Access shared learning and further information to support your work on our webpage Making progress after Francis.
All of our programmes of work have been reflecting the context in which NHS organisations are now working and you can find information and resources embedded throughout our website. Use the menu on the right of this page as a guide.
We will continue to keep you updated and work with you as you continue to implement change in your own trusts.