Francis calls for cultural change

The public enquiry report chaired by Robert Francis QC concerning the standards of hospital care provided at the Mid Staffordshire NHS Foundation Trust has emphasized a need for cultural change within the NHS.

The 3-volume, 1782-page report highlighted the failure of the NHS system to detect poor quality care and to ensure that services meet the standards that the public expects. This failure to communicate concerns illustrates a betrayal of the trust that members of the public should be able to place in the NHS.

Francis called for a patient-centred culture, which has a commitment to serve and protect patients. His recommendations for achieving this include: a structure of fundamental standards, which identify the basic standards of care a patient can expect; an openness and statutory duty of doctors and nurses to be truthful with patients; compassionate, caring and committed nursing; and stronger healthcare leadership.

The report includes a number of recommendations for changing nursing training, regulation and professional support that, if implemented, will have an impact on nurses in all sectors of the NHS, including practice nurses. Francis identified that nurses are at the heart of patient-centred care, and stressed that training standards need to be strenghthened to ensure that qualified nurses are competent to deliver compassionate care to a consistent standard. These principles apply to nurses working in all sectors of the NHS.

‘Nurses throughout the NHS will feel devastated at the picture of poor and unsafe care that took place at Mid Staffordshire,’ said RCN president Andrea Spyropoulos. ‘What commentators often forget is that no one is more saddened or frustrated by stories of poor care than nursing staff themselves.’

The report has important implications for nursing leaders, particularly for the Royal College of Nursing (RCN). Francis found that nursing needs a stronger voice. According to the report, this can be achieved through strengthening nursing representation in the leadership of all provider organizations, enhancing the links with their professional regulators, and introducing a better appraisal system. It was also recommended that the RCN consider splitting its trade union and professional functions.

Taken from Practice Nursing, published 18 Feb 2013.