NHS must ‘fundamentally change’

Stafford Hospital: NHS must ‘fundamentally change’

Robert Francis QC delivers his statement, saying: “It is a story of appalling and unnecessary suffering of hundreds of folk”

There should be a “fundamental change” within the culture of the NHS to be certain patients are cared for correctly, a public inquiry says.

The conclusion by the Francis inquiry comes after a £13m investigation into the Stafford Hospital scandal.

Previous investigations have already established in harrowing detail the abuse and neglect that contributed to the deaths of hundreds of patients.

This inquiry said the flaws went from the pinnacle to the lowest of the NHS.

The 1,781-page report catalogued missed opportunities at every turn between 2005 and 2008 – and said the findings still had relevance today four years when they first came to light in a 2009 report by the Healthcare Commission.

While it’s well-known the trust management ignored patients’ complaints, local GPs and MPs also did not speak up for them, the inquiry said.

The local primary care trust and regional health authority were too quick to trust the hospital’s management and national regulators weren’t challenging enough.

Meanwhile, the Royal College of Nursing was highlighted for not doing enough to support its members who were looking to raise concerns.


The Department of Health was also criticised for being too “remote” and embarking on “counterproductive” reorganisations.

The report said the issues created a culture where the patient was not put first.

But the inquiry – chaired by Robert Francis QC – said the change needed failed to require further reform.

Instead, it urged everyone from “porters and cleaners to the secretary of state” to interact to shift the culture.

In particular, it recommended:

  • The merger of the regulation of care into one body – two are currently involved
  • Senior managers to receive a code of conduct and the facility to disqualify them in the event that they aren’t fit to hang such positions
  • Hiding details about poor care to become a criminal offence
  • A statutory obligation on doctors and nurses for an obligation of candour so that they are open with patients about mistakes
  • An increased specialize in compassion inside the recruitment, training and education of nurses, including an inherent ability test for brand new recruits and regular checks of competence as is being rolled out for doctors

Mr Francis said: “It is a story of appalling and unnecessary suffering of hundreds of individuals.

“They were failed by a system which ignored the indicators and put corporate self-interest and price control prior to patients and their safety.

“I even have today made 290 recommendations designed to modify this culture and ensure that patients come first.

“We want a patient-centred culture, no tolerance of non-compliance with fundamental standards, openness and transparency, candour to patients, strong cultural leadership, caring compassionate nursing, and useful and accurate details about services.”

In a letter to Health Secretary Jeremy Hunt accompanying his report, Mr Francis said there had to be a “fundamental change” in culture.

Target driven

The “appalling” levels of care that caused needless deaths have already been well documented by a 2009 report by the Healthcare Commission and an independent inquiry in 2010, which was also chaired by Mr Francis.

They both criticised the price-cutting and target-chasing culture that had developed on the Mid Staffordshire Trust, which ran the hospital.

Receptionists were left to choose which patients to regard, inexperienced doctors were installed charge of critically ill patients and nurses weren’t trained ways to use vital equipment.

Cases have also been documented of patients left crying out for help because they didn’t get pain relief and foods and drinks being omitted of reach.

Some staff have said they tried to boost the alarm but were silenced by senior managers.

Helene Donnelly, who worked as an A&E nurse on the hospital, said: “It went right to the head. People didn’t wish to grasp and that’s why things got so extreme.”

Data shows there have been between 400 and 1,200 more deaths than would were expected between 2005 and 2008, even though it is impossible to mention all of those patients would have survived in the event that they had received better treatment.

While the Francis inquiry has solely considering what happened at Stafford Hospital, there may be mounting concern within the wider NHS about basic standards of care.

Recent reports by the Patients Association and Care Quality Commission have both raised the difficulty.

At the beginning of the year prime minister David Cameron said he desired to make improving care one in every of his top priorities for 2013. He’s with the aid of make an announcement at the latest report later.

Mr Cameron pointed to the cash being made available for training, particularly around dementia, the additional ward rounds being introduced in hospitals and the roll-out of the recent “friends and family” test patient survey as evidence of this.

BBC West Midlands special investigation, The Hospital That did not Care, on BBC One at 10.35pm on Wednesday 6 February.