Responding to the Francis
Report
Putting Patients First
Evonne Harding
Head of Clinical Governance/Lead Nurse
11th September 2013
Background & Timeline
• Mid Staffordshire NHS Foundation Trust:
•
•
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manages two hospitals: Stafford Hospital & Cannock Chase Hospital
provides healthcare for people in Stafford, Cannock, Rugeley and the surrounding areas,
serving a local population of over 276,500 people.
• Appalling long term failure and suffering of many patients (2005 – 2009): HCC investigation brought scandal to light, high mortality rates among patients
- Whistleblowing not acted on: Royal
College Surgeons say dysfunctional surgical
department
- Financial recovery = staff cuts
-FT: financial focus rather than quality
- New
Government
announced new public
inquiry, chaired by Robert
Francis QC
CHI 3 stars to zero
stars
2004
2005/2006
2007
2008
2009
2010
2013
Final Report published
Full scale investigation
-Peer Reviews raised concerns about cancer
& children’s services
- HCC raised concerns re children’s services
- Auditors reports identified deficiencies in
risk management systems,
- Staff & Patient surveys – worst 20% in
country
Andrew Burham announced
further independent inquiry
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What went wrong? Organisational
• Staffing Issues
• Voice of People
• Lack of Care
• Data issues
• Systems issues
• Board issues
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What went wrong 2? Other Agencies
Many Agencies failed to protect patients
• PCT/SHA/Monitor issues
• HCC/CQC
• Local MPs & GPs
• Professional Regulation (RCN, NMC, GMC)
• Others: Department of Health, Deanery/universities, HPA
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Overarching Recommendations Themes
290 Recommendations
5 Immediate Pledges
Fundamental culture & standards of behaviour change:
Responsibility for, & effectiveness
Immediate review by NHS Medical Director into 5
hospitals with high mortality rates*(Sir Bruce Keogh’s
Overview Report)
Patient, Public Involvement & Engagement and Local Scrutiny
Nursing & Medical (training and education)
Openness, Transparency and Candour
New role created of Chief Inspector of Hospitals
Effective complaints and incidents handling
Don Berwick brought in to make zero harm a reality in
the NHS (Berwick Review into Patient Safety)
Commissioning for Quality
Take advice on how hospitals should manage complaints
Joint Working & Leadership
Information
Trust boards could be suspended for quality failures as
well as losing control of the money
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Wandsworth CCG’s Mission Statement
Better Care and a Healthier Future for Wandsworth
Patient
Focused
• Involving & Engaging patients
• Supporting and Empowering
them
• Improvements in quality &
range of services provided
• Commission based on patient
Outcomes
safety, clinical effectiveness,
Driven
patient experience
• local & national strategic
priorities
• Uphold NHS Consitution
• Honesty & Integrity
Principled
• Thoughtful & Transparent
• Responsible
• Co-operation with members
• Collaboration with partner
Collaborative organisations
• Co-ordinated and patient
centred care
• Responsible to our
employees
Progressive • Respect & value diversity
&
Professional • Encourage innovation and
experiment with new ways
• Celebrate successes
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CCG’s Framework for Action Approach
Stage 1:
Quality Programmes
Stage 2:
Patient & Public
Engagement
• Clinicians at the heart of commissioning: system addressing what matters most for patients
• Quality Strategy: definition of quality, values based commissioning, quality alert systems:
• Quality Assurance Framework: 4 stage methodology
• Reflect & Gap Analysis against Francis recommendations
• Partnership working with NTDA, LA, Healthwatch, NHSE, CQC
• National Quality Reports discussed at IGC: Keogh, Berwick
• Duty of candour proposal being discussed at IGC
• Engage in South London Quality Surveillance Group meetings
• Patients’ having access to information they want to make choices
• Healthwatch strengthening their collective voice: close working with the CCG, patient
feedback
• Real-time to improve quality and timeliness of insight into patient experience (FFT, Enter &
View, Commissioner walkabouts, etc)
• Publish our Francis Framework for Action to demonstrate our acceptance of the
recommendations & our intentions
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