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The Francis Report’s Legacy

In 2010 the Mid Staffordshire NHS Foundation Trust was subject to a public enquiry, following a catalogue of failings that allegedly contributed to hundreds, or possibly thousands, of patient deaths. Sir Robert Francis QC was selected to chair the independent public inquiry. The subsequent report – known at the Francis Report – was released on 6 February 2013 and included myriad recommendations for change, many of which affected the NMC.

The report was the result of a 31-month public inquiry, and it looked closely at the level of care provided by Stafford Hospital between 2005-09. The findings revealed what led to the failings, including inadequate staffing and cost-cutting measures. According to The Guardian, the inquiry scrutinised what commissioning, supervisory and regulatory bodies in the NHS had done to identify insufficient care at Stafford Hospital, and to address it.

Helene Donnelly, head of safety culture at Nuffield Health, and a former emergency nurse at Stafford Hospital, recently wrote that during her employment at the hospital she observed issues with “patient safety, staffing levels, lack of equipment, training, falsification of records, but also
bullying and intimidation”.

Following the report, Robert Francis said, "For many patients the most basic elements of care were neglected." He also said patients often had long waits for pain relief, if they received any at all, while hygiene and toileting was often severely neglected. “Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding.” He also suggested that the hospital’s efforts to save £10 million between 2006-07 to achieve foundation trust status, was a massive contributing factor in the failings at the hospital, and further diminished an already understaffed workforce.

The results of the inquiry were damning and had far-reaching consequences. The outcome of the inquiry was one of the contributing factors to the introduction of the NMC OSCE exam. The OSCE is designed to test competency levels and the ability to apply nursing and midwifery skills in the UK. It assesses both clinical and communication skills.

It has now been a decade since the Francis Report was released, and though many positive changes have come because of the inquiry, there are concerns that cost-cutting, leadership failings, and understaffing within hospitals could lead to problems akin to those at Stafford Hospital. It is important that staff feel able to come forward with any concerns they have, and that issues are heard and appropriately addressed, to avoid future failings and unnecessary deaths. Lessons were learnt in the wake of the Francis Report, and they must not be forgotten.

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