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Windsor Ascot and Maidenhead Clinical Commissioning Group. Francis Inquiry. Sarah Bellars Director of Nursing and Clinical Quality. Introduction. 2005-2008- Poor care flourished Foundation Trust Status Meeting standards High mortality rates Patient voice
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Windsor Ascot and Maidenhead Clinical Commissioning Group Francis Inquiry Sarah Bellars Director of Nursing and Clinical Quality
Introduction • 2005-2008- Poor care flourished • Foundation Trust Status • Meeting standards • High mortality rates • Patient voice • Health Care Commission investigation 2008 • 2010 Francis report- 18 recommendation's • June 2010- Public Inquiry Francis 2 commissioned • Feb 2013- Francis 2 report published 290 recommendations.
“I heard so many stories of shocking care. These patients were not simply numbers they were husbands, wives, sons, daughters, fathers, mothers, grandparents. They were people who entered Stafford Hospital and rightly expected to be well cared for and treated. Instead, many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives.“ Robert Francis
Recommendation's • The report sets out a total of 290 recommendations. • Francis identified five themes.
1. A structure of fundamental standards and measures of compliance. • Fundamental standards patients can expect to receive and defined by the partnership between patient and provider. • Non compliance should not be tolerated and these services will be suspended • To cause death or serious harm to a patient by non compliance without reasonable excuse of the fundamental standards, should be a criminal offence • These fundamental standards should be policed by the Care Quality Commission (CQC)
2. Openness, transparency and candour throughout the system underpinned by statute. • Statutory duty to be truthful to patients where harm has or may have been caused • Staff to be obliged by statute to make their employers aware of incidents in which harm has been or may have been caused to a patient • Trusts have to be open and honest with balanced quality accounts • criminal offence if deliberate deception • The CQC should be responsible for policing these obligations
3. Improved support for caring, compassionate, and considerate nursing. • Practically based nurse training. • value based recruitment. • Nursing leadership at ward level should be enhanced. • There should be enhanced annual appraisal for all nurses and consideration for revalidation. • A new specialism in older person’s nursing should be considered. • There should be common standards of training and registration for healthcare support workers.
4. Stronger healthcare leadership • The establishment of an NHS leadership college • Ability to disqualify those guilty of serious breaches of the code of conduct. • A registration scheme for Directors
5. Accurate, useful and relevant information. • Clear widely used metrics on clinical quality. • Independent publicly available information from the NHS Information Centre. • Each clinical service must publish real-time data on patient safety and compliance with minimum quality standards. • Each provider should have a board member with a responsibility for information.
CCG • The CCG wants to ensure that it fully considers the implications from this report and the government response, as well as the recommendations for boards outlined in the report from the National Quality Board (NQB). • Providers have been formally requested to review the recommendations of this report and develop and share with the CCG plans to address gaps identified. • It is recommended to this Governing Body that a CCG implementation plan is developed with the inclusion of HealthWatchto return to the July Governing Body meeting.
CCG response continued • All Governing Body members have a responsibility to familiarise themselves with this report and all the recommendations. The full report and executive summary can be found at: http://www.midstaffspublicinquiry.com/report
"People must always come before numbers. Individual patients and their treatment are what really matters. Statistics, benchmarks and action plans are tools not ends in themselves. They should not come before patients and their experiences. This is what must be remembered by all those who design and implement policy for the NHS." Robert Francis