Hard Truths – The Government responds to Francis


19 / 11 / 2013 2.23pm

The response includes a report which outlines what the Department of Health and other national bodies have been working on since the report was published in February 2013 to tackle some of the system deficiencies identified by Francis. It also acknowledges and responds to the independent reviews into the NHS and patient care published subsequent to Francis.

The report ''Hard Truths: The Journey to putting patients first' provides a comprehensive response to each of the 290 Francis recommendations, accepting 204 in full, 57 in principle and 20 in part. Nine recommendations have not been accepted.

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 the National Inistitute of Clinical Excellence (NICE).
  • 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.

View the full report from the Department of Health's website

Read all about the Francis Inquiry

Read some examples of how the NHS locally is taking forward Francis' recommendations in our web page 'Making progress' .

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