New ‘culture of compassion’ for NHS
pharmafile | March 27, 2013 | News story | Sales and Marketing | Francis, Francis report, Hunt, Mid Staffs, NHS, Staffs
The government has launched plans to ensure that the needs of patients are paramount in any future dealings with the NHS.
These are in response to the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry by Robert Francis QC, which urged a ‘fundamental culture change’ in health and social care provision.
Among Francis’ 290 recommendations are moves to improve basic standards, create more transparency and honesty throughout the healthcare system, increase support for compassion and care in treatment, and to strengthen leadership.
NHS leaders have already acknowledged a need to repair public confidence in the light of Mid Staffs inquiry, with the Department of Health pledging “a renewed focus on putting patients at the centre of everything we do”.
Health secretary Jeremy Hunt now says that the quality of patient care will be put at the forefront of the NHS as part of an overhaul of the system.
A “culture of compassion will be a key marker of success”, he said, spelling “an end to the distorting impact of targets and box ticking which led to the failings at Stafford Hospital”.
The DH’s new measures include Ofsted-style ratings for hospitals and care homes plus a statutory duty of candour, for organisations which provide care and are registered with the Care Quality Commission.
There will also be a pilot programme in which nurses work for up to a year as a healthcare assistant as a prerequisite for receiving funding for their degree.
“The events at Stafford Hospital were a betrayal of the worst kind,” Hunt went on. “We need a radical overhaul with high quality care and compassion at its heart. But this is just the start of a fundamental change to the system.”
Mike Farrar, chief executive of the NHS Confederation, said Hunt’s response “finds the right balance between external assurance measures and internal changes focused on transforming the NHS culture”.
“There is no doubt we need immediate action to assure the public we are making every effort to put things right,” he added. “But culture change will not happen overnight.”
In its first official response to the Francis report, Healthwatch England this week commented: “It is important for us to acknowledge that patients and their families raised many concerns about failings at the hospital, and these were not listened to.”
“The system failed,” the group added – a view now seemingly shared by everyone involved, although one health policy expert was concerned that Hunt’s response may compound the problems.
David Welbourn, visiting professor in the practice of health systems management at Cass Business School, warns: “A statutory duty of candour and a threat of criminal action does nothing other than add to the fear and mistrust, when what is required is to build greater trust and genuine openness.”
Leaders need to support and equip staff to deal with work pressures, and the current environment of fear and blame hinders rather than helps, he added.
Welbourn also suggested that the focus on trainee nurses is a ‘smoke screen’ since it will be four years before this policy has any effect.
“The more pressing question is what are we doing about those already in post?” he asked. “Leaders need to be more aware of what is happening on a day-to-day basis.”
Those in charge need to spend more time setting the right tone, spending time with nurses, and increasing the time spent coaching and observing, he concluded.
Patients at Stafford Hospital were subjected to ‘appalling and unnecessary suffering’ and routinely neglected, Francis found, with hundreds dying between 2005 and 2008, many of whom were not cleaned properly or given medicines, food and drink.
Earlier this month a review of NHS complaints handling, aimed at ensuring that all hospitals listen to and act upon the concerns of patients, was also launched by the government.
The DH’s new measures include:
- Appointing an independent chief inspector of hospitals who will introduce single aggregated ratings, assess hospital complaints procedures and be the ‘nation’s whistleblower- in-chief’
- Introducing statutory ‘duty of candour’ for staff
- Publishing survival rates for ten therapy areas including cardiology, vascular and orthopaedic surgery
- Considering introduction of legal sanctions at a corporate level for providers who “knowingly generate misleading information or withhold information from patients or relatives”
- Asking General Medical Council and Nursing and Midwifery Council to tighten and speed up procedures for breaches of professional standards
- Making NHS-funded student nurses spend up to a year as healthcare assistants as a prerequisite for receiving degree funding
- Revalidating nurses – as doctors’ are now – to ensure their skills remain up to date and fit for purpose.
The government has also published a revised NHS Constitution following a recent public consultation.
Adam Hill
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