The Francis Report LMS Response Leicester Medical School
The Francis Report LMS Response Leicester Medical School
From: Communications Sent: 05 June 2013 09:38 Subject: Message from the Chief Executive Dear colleagues, There is a story running in the media today regarding a lady who was in our care in January 2012. It is distressing. There is little that we
could say in response which would satisfactorily explain how we failed this patient so badly. However, I will share what we did issue in a statement: Its clear that our failure to give Mrs Spilner intravenous fluids was a catastrophic error for which we have apologised; we know that saying sorry wont bring her back but we at least want her family to know
that we will not avoid our responsibility, we are truly sorry. As regards the equally important issue of the compassion shown to Mrs Spilner; since this happened in 2012, we have changed the nurse leadership on this ward, increased staffing levels and introduced hourly ward rounds. Again, we realise these actions will not alter anything for the family but we hope that it shows we take their experience seriously.
On 17 March 2009 the Healthcare Commission published its report into the severe failings in emergency care provided by Mid Staffordshire NHS Foundation Trust between 2005 and 2008. In response to the report, Alan Johnson, the then Secretary of State commissioned two reviews:
Professor Sir George Alberti (National Clinical Director for Emergency Care) looked at the hospitals procedures for emergency admissions and treatment and its progress against the recommendations in the Healthcare Commissions report Dr. David Colin-Thome (National Clinical Director for Primary Care) looked into how the commissioning and performance management
system failed to expose what was happening in the hospital. Both reports were published on 30th April 2009 On 21 July 2009 the Secretary of State for Health Andy Burnham announced an Independent Inquiry into care provided by Mid
Staffordshire Foundation Trust, to ensure that patients or their families have an opportunity to raise their concerns, to listen and learn from their experiences so that further lessons not already identified by previous investigations are learned. Inquiry chaired by Robert Francis QC and reported on 24th Feb 2010. This report looked at individual cases.
A Public Inquiry was set up by the Secretary of State for Health, who announced it to Parliament on 9 June 2010. The Secretary of States purpose in setting up the Inquiry was to examine the commissioning, supervisory and regulatory organisations in relation to their monitoring role at Mid Staffordshire NHS Foundation Trust between January 2005 and March 2009. The Inquiry looked at why the serious
problems at the Trust were not identified and acted on sooner, to identify important lessons to be learnt for the future of patient care. The Public Inquiry was also chaired by Robert Francis QC. The mammoth public inquiry was chaired by Robert Francis QC, right, described by solicitors
who hire him as "formidable" and "forensically exceptional". A barrister specialising in the NHS and medical negligence, he is highly skilled at getting to the truth and quietly scathing when he feels censure is due.
Stephen Dorell MP for Charnwood Chair of the Health Select Cttee Valeria Vaz MP for Walsall South
Compassion in Practice The 6Cs Care, Compassion, Competence, Communication, Courage and Commitment. Compassion in Practice (the nursing, midwifery and care staff vision and strategy for England) was launched in December 2012 at the Chief Nursing Officers Conference. Compassion in Practice was
developed with nurses, midwives and care staff up and down the country. There was an eight week engagement period prior to the launch of Compassion in Practice when spoke to over 9,000 people including nurses, midwives, care staff, patients, people we care for and stakeholders. We also used social media to engage people in the 6Cs and had over three million twitter impressions.
As well as the clear focus on the 6Cs, Compassion in Practice sets out six areas of action to concentrate our effort and create impact for our patients and the people we support. These six areas of action will be delivered together as one programme to achieve the values and behaviours of the 6Cs. Over the last three months nurses, midwives and care staff, as well
as stakeholders at national and organisational level, have developed implementation plans to support the delivery of the values and behaviours of the 6Cs. To find out more and to see the implementation plans visit: www.commissioningboard. nhs.uk/nursingvision
Requirement All commissioning, service provision regulatory and ancillary organisations in healthcare should consider the findings and recommendations of this report and decide how to apply them to their own work.
Each such organisation should announce at the earliest practicable time its decision on the extent to which it accepts the recommendations and what it intends to do to implement those accepted, and thereafter, on a regular basis but not less than once a year, publish in a report information regarding its
progress in relation to its planned actions. A shared culture in which the patient is the priority in everything done. A system which recognises and applies the values of transparency, honesty and candour.
Staff put patients before themselves. They will do everything in their power to protect patients from avoidable harm. They will be honest and open with patients regardless of the consequences for themselves. Where they are unable to provide the assistance a patient needs,
they will direct them where possible to those who can do so. They will apply the NHS values in all their work. Fundamental standards of behaviour Reporting of incidents of concern relevant to patient safety, compliance with fundamental standards or
some higher requirement of the employer needs to be not only encouraged but insisted upon. Staff are entitled to receive feedback in relation to any report they make, including information about any action taken or reasons for not acting.
Fundamental standards of minimum safety and quality in respect of which non-compliance should not be tolerated. Patient Safety
Your knowledge! Scientific knowledge Apprenticeship Knowing your limitations (however, there is often not a senior person immediately available)
Your caring! What do you understand by caring? Does it have any limitations for students/doctors? Selection? Does the medical school promote caring or erode it?
Your resilience! Discussion groups 1. 2. 3.
4. 5. 6. 7. Student selection
Caring (emotional) Interprofessional caring Whistleblowing. Carers/student Do you feel apprenticed? Resilience Caring (knowledge)
Change has to occur, but: The Medical School wants to change but only if the change will improve patient care. In other words any changes must be patient focussed, not
politically driven! Examples of outcomes from discussion groups All 1st year students should spend day a week on
the wards as a volunteer Health Care Assistant All 2nd year students should spend a day a week on the ward as a volunteer Nurse Assistant The Medical School should clarify the pathways through which students should raise concerns about fellow students
The Medical School should clarify the pathways through which students should raise concerns about patient care
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