Publication of the Inquiry into standards of care at Mid-Staffordshire NHS Foundation Trust and NHS Chief Executive’s re

25 February 2010

Publication of the Inquiry into standards of care at Mid-Staffordshire NHS Foundation Trust and NHS Chief Executive’s recommendations

Report

Robert Francis QC’s report (“the report”) into standards of care at Mid-Staffordshire NHS Foundation Trust was published yesterday, it makes various recommendations. The NHS Chief Executive; Sir David Nicholson, has written to all chairs and chief executives asking them to read the report and review the standards of care in their Trusts in order to ensure that high standards of care are achieved. He makes specific recommendations concerning the report that have general application to the NHS. We provide a brief summary of these below.

Standards, governance and performance

Sir David asks all NHS boards to urgently review standards, governance and performance in the light of the report. He states: “My expectation is that every NHS board reads the report in full, but also actively considers the implications for the way that you do your business; how you as a board assure yourselves and the community that you serve of the quality and safety of the services you provide and commission.”

Care Quality Commission (“CQC”), care and efficiency

Hospital Trusts are reminded of the need to register and make appropriate declarations with the CQC and the need to publish Quality Accounts from mid 2010: these will be the public-facing account of the quality of care provided by a hospital. Increasing productivity should be driven by the desire to improve quality and Sir David also states: “We know that poor quality care is often inefficient care and that we will release the necessary efficiencies by focussing our attention on quality, innovation and prevention.”

Senior managers’ accreditation to be introduced

A new system of professional accreditation for senior managers will be implemented following consultation on the best means of introduction. This will involve reviewing the arrangements for the training, appointment, support and accountability of executive Directors of NHS and Foundation Trusts. Whether non-executive directors will be included remains to be decided.

The single hospital standardisation mortality ratio (“HSMR”) and failing hospitals

The development of a HSMR and a guide to its use; written by the NHS Confederation, is to be introduced. Robert Francis QC will chair a further inquiry into the role of external agencies that will identify failing hospitals.

Assistance

These issues will require some advice relating to corporate and clinical governance, general regulation and healthcare law issues. There may also be capability and performance issues to consider. If you require legal assistance Hill Dickinson’s specialist healthcare and NHS teams provide that help.

Links to documents (dated 24.02.2010)

Set out below, we have created a set of links which will allow you to access the report and information which we hope will be useful.

• Download Francis Inquiry Report - Vol 1
• Download Francis Inquiry Report - Vol 2 (Inquiry witness testimonies)
• Sir David Nicholson letter to all NHS Chairs and Chief Executives
• Department of Health press notice
• Review of Early Warning Systems in the NHS
• Assuring the Quality of NHS Senior Managers and associated research
• The Healthy NHS Board
• Joint statement about HSMRs

Wales

The letter is not directly applicable to NHS Wales but LHBs may wish to consider the recommendations in any event.

Allan Mowat
Partner
allan.mowat@hilldickinson.com
+44 (0)151 600 8298

Contacts

If you would like any help with the issues that arise out of this report, the contact details of people within Hill Dickinson who can help you are set out below:

Healthcare:

Allan Mowat
Partner
Allan.Mowat@hilldickinson.com
+44 (0) 151 600 8298

Emma Di Giacomo
Solicitor
Emma.DiGiacomo@hilldickinson.com
+44 (0) 151 600 8173

David Hill
Solicitor
David.Hill@hilldickinson.com
+44 (0) 151 600 8195

Employment:

James Upton
Partner
James.Upton@hilldickinson.com
+44 (0) 161 817 7262

Sue Morrison
Partner
Sue.Morrison@hilldickinson.com
+44 (0) 161 817 7327

Andrew Gibson
Partner
Andrew.Gibson@hilldickinson.com
+44 (0) 1244 896 627