“Not end but the beginning of a journey towards a healthier culture in the NHS.”
Robert Francis, QC
In February 2013 Robert Francis, QC published a report into what contributed to the failings at Mid Staffordshire NHS Foundation Trust. The ‘Francis report’ said that that a fundamental change in culture was needed that will put patients where they are in entitled to be, in Francis’s own words, “the first and foremost consideration of the system and all those who work in it.”
On the publication of the report the Academy stated its belief that the delivery of quality care is a shared responsibility and all parts of the healthcare system – politicians, national leaders, managers and clinicians – must really listen to and hear what is said to them by patients and carers to ensure that quality of care, patient safety and patient experience are truly the central drivers of what happens in the NHS.
Following the publication of the report the Academy, through its Quality Improvement Leads Committee, has looked at all Francis’s recommendations. A seminar in April looked at which recommendations were most relevant to the Academy and the colleges. The Academy decided that it and its member Colleges and faculties can best play their part in working to ensure that the circumstances in Mid Staffordshire are not repeated and that we continually improve patient care in three areas:
Standards for delivery of clinical services
To ensure high quality patient experiences and outcomes, care has to be consistently delivered to agreed clinical standards. The Academy will continue to support the design, implementation and review of clinical standards and the processes for assuring their use. This work will be taken forward and coordinated by our Quality Improvement Leads Committee and includes:
- Defining what a ‘patient-centred’ actually means in relation to how the Academy and Colleges operates.
- Ensuring the Academy has a view on valid, reliable, useful data of value to clinicians and patients
- Working with the NHS Confederation on supporting clinicians and managers in making decisions that balance quality and cost
- Agreeing with CQC how Colleges can work with them to:
- Share audit and accreditation information
- Contribute to development of any rating system
- Support the inspection process.
Standards for delivery of education and training
To ensure the delivery of high quality patient care doctors must be appropriately skilled as technical and caring practitioners. The Academy will continue to support the design, implementation and review of education and training standards and the processes for assuring their use. The majority of this work will be taken forward by our Education Committees and includes:
- Working with the GMC to agree and implement how medical Royal Colleges/Faculties will contribute to quality assurance of training environments
- Develop a clear proposal for what medical Royal Colleges/ Faculties / the Academy can do to strengthen the amount of time consultants have to give and receive training.
Quality improvement responsibilities of individual doctors
To promote a caring NHS culture individual clinicians must take personal responsibility for delivering safe, evidence-based, compassionate, and ever improving care. The process of revalidation offers an opportunity for doctors to reflect on their personal contribution and responsibility for the improvement of quality. The Academy will develop the support it can offer to individual doctors in identifying and implementing improvements in patient care. The Quality Improvement Leads and Education Committees will:
- Develop a clear proposal for what medical Royal Colleges/Faculties can do and what the Faculty of Medical Leadership and Management can do to strengthen patient and medical leadership competencies in all current and future medical leadership
- Develop a simple set of signposting/good practice resources for use by medical Royal Colleges/Faculties in supporting clinicians to speak up.
The Academy will seek to undertake all this work in a patient-focused way and in conjunction with key partners.
Access the full on-line Francis Report.