20.11.13
DH accepts most Francis recommendations in ‘trust blueprint’
The government has accepted 281 out of 290 of the Francis Inquiry’s recommendations, health secretary Jeremy Hunt has announced. This includes 57 ‘in principle’ and 20 ‘in part’, where there are some differences or new ideas about how the recommendation will be delivered.
Hunt said: “I do not simply want to prevent another Mid Staffs. I want our NHS to be a beacon across the world not just for its equity, but its excellence. I want it to offer the safest, most compassionate and most effective care available anywhere – and I believe it can.”
To increase transparency and accountability, all NHS organisations and staff will be required to be open with patients about any incidents, avoidable harm or ‘near misses’. Regulators will introduce a new professional duty of candour for staff to encourage a culture of learning from mistakes, rather than the silence that led to such disastrous care at Mid Staffs.
Perhaps one of the most controversial recommendations from Francis, and repeated in the Cavendish review, was to introduce mandatory regulation/registration for healthcare assistants (HCAs). The government is instead bringing in a new Care Certificate for HCAs and social care support workers.
In its response, the DH stated that there was “no solid evidence that demonstrates that healthcare and care support workers should be subject to compulsory statutory regulation, given the safeguards that are already in the system”.
Where employers find that a HCA or social care support worker no longer meets the standards in the Care Certificate, HEE and the Sector Skills Councils will set out guidance to ensure appropriate retraining or disciplinary action is taken.
From next April, all hospitals will publish staffing levels on a ward-by-ward basis each month. While some organisations had called for national minimum staffing levels, the Chief Nursing Officer pointed out that the necessary ratios of staff would differ from hospital to hospital. Hospital boards will be required to review these numbers every six months. A national safety website will also publish information on a monthly basis.
The DH has announced a new national patient safety programme to build safety skills across England, while NHS England will train and appoint 5,000 ‘patient safety fellows’ to lead on patient safety work. This programme will be rolled out over the next five years.
In terms of complaints, trusts will move to quarterly complaints reporting and be required to provide better complaints information, including the lessons learnt. The Health Service Ombudsman will consider a larger number of cases and the government is looking into how improved reporting of safety incidents can be achieved.
To make it easier for patients to complain, and meeting a recommendation from both the Francis and the Putting Patients back in the Picture reviews, every hospital patient will now have the names of the responsible consultant and nurse above their beds.
A new criminal offence for wilful neglect was proposed earlier this year, in response to the Berwick Review. The CQC will also introduce a new ‘Fit and Proper Person’s Test’ to stop senior managers from taking up posts elsewhere in the system after past failures.
In a bid to reduce bureaucracy, NHS organisations have agreed to limit this burden on frontline organisations and staff.
Hunt added: “Today’s measures are a blueprint for restoring trust in the NHS, reinforcing professional pride in NHS frontline staff and above all giving confidence to patients. I want every patient in every hospital to have confidence that they will be given the best and safest care and the way to do that is to be completely open and transparent.”
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