NHS Confederation and NHS Employers respond to Government statement on the Francis Report

Dean Royles

26 / 3 / 2013 Midnight

NHS Employers: We need to recognise great compassionate care in the NHS and build on it. 

NHS Confederation: We must keep a relentless focus on creating an NHS that is safer, more compassionate and fully accountable to the people it serves
Dean Royles, chief executive of the NHS Employers organisation, said:

"The Government set itself an almost impossible task of responding quickly to such an important forensic report.  It is better to take an initial approach now than rushing to a line by line response, allowing more time and opportunity for patients, the public, and the NHS to further engage in the detail of implementation. As an organisation, NHS Employers is committed to continuing to support the NHS in the changes needed post-Francis.

"There has been a lot of discussion about the need for a culture change in the NHS, and we should not deny that this is a problem in some parts of the service. But the NHS delivers great compassionate care much of the time, and we need to recognise this and build on it where it is working well for patients. We can't say that poor care is because of culture but excellent care exists despite it.

"Quality care is not just about seeing every patient as an individual, but also about the system working in harmony, delivering timely care in the right place each and every time. Getting this right requires strong leadership and collaboration. Employers, of course, will support the principle of openness and transparency so a duty of candour makes sense. But we need to beware the law of unintended consequences. You don't improve culture by creating a climate of fear. 

"We are pleased to see the focus from Government on staff and particularly on recruitment and training. Getting training right most of the time isn't good enough - investment in training is an investment in care. It is important we do not focus exclusively on nursing at the expense of other professions; modern healthcare is about multidisciplinary working. All staff need good skills and a compassionate heart – it is not a question of one or the other. We look forward to working with Health Education England and others to introduce and evaluate carefully the pilots for ensuring student nurses gain further experience in frontline caring. 

"The minimum standards and code of conduct for healthcare assistants will provide support to employers in ensuring effective training and support for this key staff group.

"Regulation of healthcare assistants would have been the wrong response to wrong the question. You can't regulate for kindness and compassion but we can do more to test that people wanting to train in healthcare have the right values, and the right access to training and to good supervision. 

“There is an unwavering commitment from employers to tackle failings in care and ensure patients, their carers and families, feel confident in the care they receive. We will continue to support the good work many employers have already undertaken on engaging and listening to staff, and on values based recruitment and training  and creating an open and honest culture.”


Mike Farrar, chief executive of the NHS Confederation, said:

"The Government has used this time to produce an overarching response rather than a something which tries to tick all the boxes. The response finds the right balance between external assurance measures and internal changes focused on transforming the NHS culture. 

"The NHS now has a real opportunity to do things differently, and it is the responsibility of all of us to make a real difference to the care provided to patients. 

"There is no doubt we need immediate action to assure the public we are making every effort to put things right. But culture change will not happen overnight. All of us, from the ward to Whitehall, will need to keep a relentless focus on the long term goal - creating an NHS that is safer, more compassionate and fully accountable to the people it serves. 

"We are encouraged to see the Government has swiftly taken on board the ten initial recommendations of our bureaucracy review, which will ultimately free staff to care for patients.

"I am also pleased that the Government has placed a real emphasis on respect and dignity, something we have been working hard to achieve through our joint Dignity Commission. We need an NHS that puts compassion right at the heart of care, one that views every patient as an individual. And we need an NHS that is smarter in the way it uses information, not one that drowns staff in requests for more and more data. 

"We remain committed to working with our members, patients and the public on these issues to consider the best ways to make a positive and lasting change.

"We fully support the principles of a duty of candour and believe NHS organisations should be fully accountable to taxpayers and the very people they serve. Only by being fully transparent can organisations learn how to improve when things go wrong. We need to listen to patients and act on their genuine concerns. The failure to do this at Mid Staffs resulted in tragic consequences - we cannot let that happen again. 

"The Government is asking each and every hospital to set out how they will respond to the Inquiry's conclusions by the end of this year. That work has already started, and many hospitals are already working hard to put patients at the heart of everything that they do. This now needs to become the norm right across the board.

"We will be working with our members to support their work on this."

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