Introduction – From Anne O’Brien, NHS Professionals’ Director of Clinical Governance & Operations
Many of you will have read over the last few months, indeed years, the damning stories of poor care, treatment and neglect of the patients reported at Stafford Hospital. While NHS Professionals does not provide flexible workers to this Trust, there are a number of issues that we can all learn from, things we need to understand and changes we need to make. A number of you will no doubt have received information on the Francis Report from your Trusts. However, as the biggest supplier of temporary staff to the NHS, it is important that we provide an overview for all our flexible workers.
NHS Professionals is committed to continuous improvement and, over the past five years, has made many changes to both how it operates and how it provides its services to Trusts. Those of you who have been with us for some time will have seen these improvements. As with all things there is still room for us all to improve and learn, so I will be setting out some of the plans that NHS Professionals has, what is already available, as well as what you can do to ensure we help Trusts deliver the best care possible to patients, service users, their carers and families.
What is the Francis report?
On the 15th September 2009, an independent inquiry was launched into care provided by Mid Staffordshire NHS Foundation Trust between 2005 and 2009. The inquiry was chaired by Robert Francis QC and his final report was published in February 2010. The report concluded that patients were routinely neglected by the Trust, which was preoccupied with cost cutting, targets and processes, and which lost sight of its fundamental responsibility to provide safe care.
The evidence gathered by the inquiry shows clearly that, for many patients, the most basic elements of care were neglected. It found that a chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care. Morale at the Trust was low, and while many staff did their best in difficult circumstances, others showed a disturbing lack of compassion towards their patients. Staff who spoke out felt ignored and there is strong evidence that many were deterred from doing so through fear and bullying.
Despite the findings of the inquiry, Robert Francis QC concluded that Stafford Hospital should not be closed. He believed that while there is still much work required at the Trust, the new executive team had made a successful start in improving the safety and quality of care it provides. A public inquiry was then launched and a subsequent report was published in February 2013 with 290 recommendations.
How does this affect me?
• Putting Patients First
You should always demonstrate care and compassion and guarantee dignity to all patients.
• Openness, transparency and candour
You should be honest, open and truthful in all dealings with patients and the public. Organisational and personal interests must never outweigh that duty.
• Caring for the elderly
You should work as part of the team and support your colleagues when on an assignment to ensure patients receive the required level of care and attention.
What is NHS Professionals doing to implement recommendations from the Francis Report?
I understand that our rigorous processes can be a cause for some frustration from time-to-time; however you will be pleased to learn that the following initiatives mean that our flexible workers are proven to meet the required standard to provide care.
• Knowledge Based Assessment as part of the recruitment process for 27 staff roles, including Registered Nurse, Registered Midwife, Care Support Workers and Allied Health Professionals, which include questions relating to values, dignity and respect;
• Flexible Worker Code of Behaviour, which includes the values of being caring, reliable and professional;
• E-learning modules to support Flexible Worker development including Compassion and Dignity for All, Early Warning Systems to recognise the deteriorating patient, Clinical observations and their interpretation and Mental Health Observations
• Performance Evaluation for all staff groups asking for feedback on the performance of a flexible worker on a particular shift based on the Knowledge and Skills Framework;
• Orientation schedule for flexible workers to ensure they receive up to date information relating to a ward area when they are new to the environment;
• Placement Expectation Guidelines for Client Trusts so that each service area can know what to expect from an NHS Professionals Flexible Worker.