Mid Staffordshire NHSFT Public Inquiry

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1 REPORT TO THE TRUST BOARD 28 February 2013 C Title Mid Staffordshire NHSFT Public Inquiry Executive summary The purpose of this report is to present the recommendations of the Francis Report and confirm that a considered review of the findings has commenced within the Trust. On Wednesday 06 February 2013, Sir Robert Francis Report published his report outlining the failure of care at the Mid Staffordshire NHS Foundation Trust. The report described a lack of care, compassion and leadership across the whole health economy and identified a number of findings under five key themes against these failures. There are 290 recommendations for change within the NHS as a whole based on this analysis. The Trust recognises that in response to the recommendations, every member of the Trust s staff and our stakeholders have an important part to play in actions we take in response to this report. The findings resonate strongly with the Trust s existing strategic vision of An Integrated Foundation Trust with a passion for quality and excellence and the intensive work already in progress to improve quality of care across our portfolio of services. Recommendations The Trust Board is asked to: i. Consider the Francis report and note that the recommendations are under review. ii. iii. iv. Note that the Trust has begun full engagement with staff to ensure that any resulting actions are informed from across the Trust irrespective of role or level within the Trust. Note that the Trust is engaged in discussions with wider stakeholders within the local health economy, including commissioners and other providers to ensure a collective response is achieved within Leicester, Leicestershire and Rutland. Note that the full recommendations will be considered at Trust Board in March to agree application and confirm next steps.

2 Related Trust objectives Risk and assurance Legal implications/ regulatory requirements Presenting Director The implications of this report relate to all our strategic objectives. None identified. The legal implications and regulatory requirements will be assessed as part of the DH/Commissiong/Provider response. Jackie Ardley Chief Nurse Dr Sab Bhaumik Medical Director Author(s) Jackie Ardley, Executive Director of Quality and Innovation / Chief Nurse Bal Johal Head of QPP *Disclaimer: This report is submitted to the Trust Board for amendment or approval as appropriate. It should not be regarded or published as Trust Policy until it is formally agreed at the Board meeting, which the press and public are entitled to attend.

3 1. Introduction 1.1 On Wednesday 06 February 2013, Sir Robert Francis Report published his report outlining the failure of care at the Mid Staffordshire NHS Foundation Trust. The report described a lack of care, compassion and leadership across the whole health economy and identified a number of findings under five key themes against these failures. There are 290 recommendations for change within the NHS as a whole based on this analysis The Trust recognises that in response to the recommendations, every member of the Trust s staff and our stakeholders have an important part to play in actions we take in response to this report.. The findings resonate strongly with the Trust s existing strategic vision of An Integrated Foundation trust with a passion for quality and excellence and the intensive work already in progress to improve quality of care across our portfolio of services 1.2 Full copies of the executive summary, inquiry and supporting papers can be found at 2. Recommendations The Trust Board is asked to: i. Consider the Francis report and note that the recommendations are under review. ii. iii. iv. Note that the Trust has begun full engagement with staff to ensure that any resulting actions are informed from across the Trust irrespective of role or level within the Trust. Note that the Trust is engaged in discussions with wider stakeholders within the local health economy, including commissioners and other providers to ensure a collective response is achieved within Leicester, Leicestershire and Rutland. Note that the full recommendations will be considered at Trust Board in March to agree application and confirm next steps. 3. Summary of Recommendation Themes The recommendations are grouped according to themes identified by the inquiry, of which there are five. These five themes include recommendations that extend beyond the remit/authority of a provider Trust, (for example the role of HealthWatch); therefore it is necessary for the Trust to identify those recommendations that require a specific provider response along with those where collaborative work is needed with other local stakeholders.

4 The five themes are: Fundamental standards of care with rigorous inspection and sanctions should be created. Standards to be defined by patients and public and should include staffing. Non-compliance should not be tolerated. Openness transparency and candour are essential. Every healthcare organisation and everyone working for them must be honest, open and truthful in all their dealings with patients and the public, and organisational and personal interests must never be allowed to outweigh the duty to be honest, open and truthful. Proper standards of nursing care are required. An increased focus on the caring aspect of the nursing role is needed. There should be values-based assessment for entry to profession and training must include hands on education. Healthcare support workers need adequate training and regulation. No one should provide hands on care if not properly trained and registered to do so. Strong patient-centred leadership is needed. The report recommends that an NHS Leadership College should be established to promote common training for senior NHS staff. Leaders should be held to account for failures of care Accurate and useful information should be available. More sophisticated information is needed to demonstrate compliance with fundamental standards. The Trust Board is accountable for compliance with fundamental standards and it should be a criminal offence to wilfully omit information. There are two immediate recommendations which should be our initial focus for discussion and action. These are: Recommendation one - requires all service providers to consider the findings and recommendations of the Francis Report and decide how to apply them to their own work. Recommendation Two - requires each organisation to announce at the earliest practicable time its decision on the extent to which it accepts the recommendations and what it needs to do to implement those accepted. 4. Discussion National Response 4.1 It should be noted that, whilst a number of Ministerial statements, statements by national bodies and political commentary has been made, the Department of Health has not yet formally responded to the Public Inquiry report Local Response 4.2 Local NHS and other statutory partners will need to come together to inform a local system wide discussion to ensure that: Collective learning is achieved from failings identified within the Francis Report

5 A coordinated response is made within Leicester, Leicestershire and Rutland. Along with the work to address provider specific recommendations at LPT the outputs of the local response will form future reports to the Trust Board from March 2013 onwards so that there is transparency and assurance for local people in meeting the challenges and recommendations the Francis report describes. 4.3 The Francis report was analysed by the Executive Team on 06 February 2013 and then was the subject of more detailed discussions with Divisional and Clinical Directors on 18 th February and our Quality Assurance committee on 19 February where it was resolved not to present a paper in advance of considered discussions and the full engagement of staff in developing the our response. 4.4 Engagement with all Trust staff has already begun with a number of briefings issued to staff and published on the Trust Intranet. In addition the Chairman and Chief Executive have written a letter that has been sent to every member of staff encouraging them to properly engage in the response to the Francis Report; this involves ensuring staff feel supported and empowered to raise any behaviours and barriers to delivering high quality care. The letter also seeks to ensure that teams openly discuss the report and how it affects the work they undertake. It should be noted that this encouragement extends beyond those involved in the delivery of hands on care, as our vision statement clearly states that all our staff are part of the process and accountability for delivering high quality services. 5. Conclusion 5.1 This report highlights at a high level the key recommendations from the Francis Report and the local response both within the local health system and internally within the Trust with the emphasis on staff engagement and ensuring the response to this report is embedded into the Trust s governance framework. There will be a number of actions required within the Trust which will be the subject of future Board reports, supported by work taking place in response to the recommendations within our Board Committees and across the workforce. Appendix 1 shows a copy of the letter sent to all staff along with an initial list of web links to statements made by some national bodies.

6 Appendix 1 A Message to all staff from our Chairman David Chiddick and Chief Executive John Short Together we must take on board the findings of the Francis Report and tackle any barriers and behaviours that prevent us achieving excellence. We know on many occasions our dedicated staff deliver high quality care, very often going above and beyond what is required. However we can all recognise where there are examples of poor care. We need to challenge one another about this, especially the view (from a minority) that patient care is somehow someone else s responsibility. We need to support each other to improve. The Francis Report asks everyone to: Ensure patient care is first and foremost in our minds Examine our individual and collective responsibilities in caring for patients Look carefully at the quality of care we provide in the NHS Be open and transparent in our work At LPT we are striving for excellence in the service we provide for local people: Our vision to be an organisation with a passion for quality and excellence stands firm. Our number one priority remains delivering quality care. We all want LPT to be an exemplary place to work, where care and compassion can flourish. Every member of the Trust is vital to this process. We need to hear from you directly and we need your help to make this a reality. Please take time in your team to discuss the Francis Report, and consider what is needed on the ground, where you are, to break down those barriers and then give us your feedback either through your team leader and/or individually via You have our commitment as a Board to listen and respond to your feedback. Together we can continue to be proud of the NHS and our part in it. David Chiddick and John Short, February 2013 Academy of Medical Royal Colleges Action Against Medical Accidents Age UK Alzheimer's Society British Medical Association British Prime Minister's Office Care Quality Commission Carers UK Centre for Innovation in Health Management Centre for Workforce Intelligence Department of Health Foundation Trust Network General Medical Council General Pharmaceutical Council The Health Foundation Health Service Ombudsman Help the Hospices House of Commons Health Select Committee Institute of Healthcare Management

7 The King's Fund Local Government Association Macmillan Cancer Care Marie Curie Cancer Care Monitor National Council for Palliative Care Nursing & Midwifery Council National Voices NAVCA NHS Alliance NHS Commissioning Board NHS Confederation The Nuffield Trust The Patients Association Reform Royal College of General Practioners Royal College of Midwives Royal College of Nursing Royal College of Obstetricians and Gynaecologists Royal College of Paediatrics and Child Health Royal College of Physicians Royal College of Surgeons Royal College of Surgeons of Edinburgh Royal Pharmaceutical Society Queen's Nursing Institute Skills for Care TUC UK Faculty of Public Health Unite

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