The implications of the Francis report (Obstetrics, Gynaecology & Reproductive Medicine)

The implications of the Francis report
PD Simpson, EP Morris – Obstetrics, Gynaecology & Reproductive Medicine, 2014

of inadequate staff numbers and poor training as well as a lack of leadership and poor The report’s conclusion was that ‘All NHS Trusts and Foundation trusts responsible for the provision of It was published in February 2013 and has had a significant impact on the health

The failings seen at the Mid Staffordshire NHS trust have been thoroughly investigated by an independent inquiry and a public inquiry, both chaired by Robert Francis QC. The report into the failings of the healthcare governance system was published in February 2013. This review article explores the content of the ‘Francis report’ and aims to highlight the implications it has on practice within Obstetrics & Gynaecology, in particular, how the lessons learnt fit into the strategic plan set out by the Royal College. The events at Mid Staffordshire have had far reaching consequences within the NHS and we must all consider what our speciality must do to ensure an appropriate response.

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Public consultation on Mid Staffs

A public consultation on the future of Stafford Hospital opens later.

Administrators have said Mid Staffordshire NHS Trust should be dissolved, with many services at Stafford Hospital taken on by nearby hospitals.  Under the plans, maternity services and seriously ill children would no longer be treated at Stafford.

The proposals, announced last Wednesday, were initially met with criticism by people in the area.

Extract from BBC Health news

Also in the news:  Doctors in Stoke-on-Trent are insisting the city’s hospital will be able to cope if services are moved there from Stafford Hospital.

Hospitals care failings

Extract from BBC News

Failings in care and problems with staffing at the 14 hospital trusts with the worst death rates in England are to be exposed.

A  report was ordered amid concern that failing hospitals were not being held to account following the criticisms of the Francis Inquiry into Stafford Hospital, which said the public had been betrayed by a system which put “corporate self-interest” ahead of patients.

Its understood the Keogh report – as well as flagging up management failings – will also point to concerns over nurse staffing levels in the 14 hospitals under investigation.

The report will suggest there is a link between inadequate staffing levels and poor standards of care.

Its expected the report will say: “When the review teams visited the hospitals, they found frequent examples of inadequate numbers of nursing staff in some ward areas.”

Sir Bruce Keogh’s report will say all 14 hospitals are undertaking an urgent review of “safe staffing levels.”

The trusts investigated, which run a total of 19 acute hospitals, are the ones with the highest death rates in 2010-11 and 2011-12. They are:

• Basildon and Thurrock University Hospitals NHS Foundation Trust

• Blackpool Teaching Hospitals NHS Foundation Trust

• Buckinghamshire Healthcare NHS Trust (Two hospitals – Stoke Mandeville and Wycombe)

• Burton Hospitals NHS Foundation Trust

• Colchester Hospital University NHS Foundation Trust

• The Dudley Group NHS Foundation Trust

• East Lancashire Hospitals NHS Trust (Two hospitals – Burnley General and Royal Blackburn)

• George Eliot Hospital NHS Trust

• Medway NHS Foundation Trust

• North Cumbria University Hospitals NHS Trust (Two hospitals – Cumberland Infirmary and West Cumberland)

• Northern Lincolnshire and Goole Hospitals NHS Foundation Trust (Three hospitals – Diana, Princess of Wales Hospital, Goole and District Hospital and Scunthorpe General)

• Sherwood Forest Hospitals NHS Foundation Trust

• Tameside Hospital NHS Foundation Trust

• United Lincolnshire Hospitals NHS Trust

At the moment, regulatory action is being taken against six of the trusts, but none is facing the ultimate sanctions of fines, closure of individual units or administration of the entire organisation.

This week in healthcare: 18 February 2013

As doctors call for pregnant women to be tested for alcohol intake, Channel 4 News has spoken to youngsters left permanently brain damaged by their mothers’ drinking. Tomorrow nearly 70 medical professionals and the FASD Trust will publish the first clear guidance into Foetal Alcohol Spectrum Disorders.

Whistleblowing legislation is to be overhauled and a government consultation held to investigate whether the Public Interest Disclosure Act (Pida) 1998 is failing to protect those who speak out from being victimised, harassed and even sacked by their employers.

Fizzy drink – what’s the cost?

In today’s news, the Guardian reports that the Academy of Medical Royal Colleges has put forward a 10-point action plan to help end UK’s status as the ‘fat man of Europe’. Britain’s 220,000 doctors are demanding a 20% increase in the cost of sugary drinks, fewer fast food outlets near schools and a ban on unhealthy food in hospitals.

The Telegraph reports that baby formula milk should carry bigger cigarette packet-style warnings that breastfeeding would be better, Save the Children has claimed.Also on the Guardian, Staffordshire’s police and crime commissioner says detectives are examining ‘information not in the public domain’ in regards to the Mid Staffordshire scandal.


Elsewhere, health secretary Jeremy Hunt has warned NHS bosses against allowing a culture that is “legalistic and defensive” in dealing with staff who raise concerns over patient care, according to the BBC. Hunt says in the letter:

“I would ask you to pay very serious heed to the warning from Mid Staffordshire that a culture which is legalistic and defensive in responding to reasonable challenges and concerns can all too easily permit the persistence of poor and unacceptable care.”

The long awaited Mid-Staffs Public Enquiry: Report published

The final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry was published today, Wednesday 6 February 2013. Please use the links below to access the executive summary and a full copy of the report, along with the Chairman’s public statement on the day.

Read the report

Statement by the Chair of the Inquiry, Robert Francis QC.  This video content will be available shortly.

Key facts and figures

Download PDF