The Francis Inquiry

Doctor inserting drip

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.
  • 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.
  • 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.


Francis: How NHS Employers is supporting you

NHS Employers has been commissioned by the Department of Health to support the NHS with staff engagement, organisational development and health and wellbeing. 


The reports: Clwyd-Hart, Keogh, Cavendish and Berwick

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.

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Making progress after Francis

NHS organisations are continuing to improve their services and provide quality patient care. Here you can find examples of onging progress in meeting the recommendations made by Robert Francis QC.

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Francis: one year on

6 February 2014 marks the first anniversary of the publication of the Francis report. We have produced a series of materials to support you in responding to the recommendations in the report.

Hospital doctors

Guidance: Safe staffing and Human Factors

To support the implementation of some of the Francis recommendations, the National Quality Board (NQB) has published two sets of guidance.


Regulation and Standards

There are many regulations and standards employers need to be aware of in relation to recruitment and the ongoing employment of staff.

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The Government response to Francis

In March 2013 the Government issued its response to the report from Robert Francis QC into Mid Staffordshire NHS Trust Public Inquiry and sets out initial actions to be taken.

Open book

Tools, resources and further information

We have a variety of tools, resources and information to support the HR community in responding to the Francis report's recommendations and the shift towards an improved culture.

staff in a meeting

NHS Employers and Robertson Cooper

This roundtable was the first of a series of activities to gather the views of NHS staff on the issue of emotional wellbeing, what it looks like, how we can measure it, the impact it has on us and how we can make changes to improve.

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