The result of the public inquiry into Mid Staffordshire NHS Foundation Trust, which is the Trust responsible for Stafford Hospital, was published on 6th February 2013.
In his report, Mr Francis QC outlines some 290 recommendations as a result of his investigation into not only what happened at Stafford Hospital between January 2005 and March 2009, but why the complex system of checks and balances that governs the National Health Service failed to pick up and deal with the deficiencies before and even after they became apparent.
Perhaps the most shocking aspect of the report is that Mr Francis QC has felt the need to make specific recommendations about what I am sure many of us would consider the most basic aspect of healthcare: that the patient should be at the heart of the system.
On the back of his criticisms of what he termed the “insidious negative culture involving a tolerance of poor standards” and, in part, “the consequence of allowing a focus on reaching national targets, achieving financial balance and seeking Foundation Trust status”, Mr Francis QC identifies the need for the NHS as a whole to re-establish a “common culture…of putting the patient first” and, in his recommendations, reiterates that “patients must be the first priority in all of what the NHS does.”
The sheer scale of the recommendations makes it impossible to cover all aspects here, but of particular relevance to patients who feel that they have suffered from poor or even negligent treatment are Mr Francis QC’s recommendations in relation to effective complaint handling.
Recommendation number 110 of Mr Francis QC’s report suggests that the duty to respond to a patient’s complaint should be treated entirely separately to any legal claim, so unless it would be appropriate in the circumstances of the patient’s case to delay the legal claim pending the outcome of the complaint, the two processes should be able to continue side-by-side.
If implemented, this will rightly provide patients with the ability to raise and receive a response to their concerns about poor quality care such as a lack of help with toileting and hygiene, staff attitude or a lack of privacy and dignity whilst a separate legal claim is ongoing. These kinds of complaints, which would not normally result in a claim for negligence as stand-alone issues, can have just as much impact upon a vulnerable patient as an incorrectly performed surgery or being given the wrong drug and so it is equally important for patients to receive a response to these concerns as it would be for them to achieve a successful outcome to their legal claim.
Mr Francis QC’s report has already had an impact with five additional NHS Trusts now under investigation for higher than expected death rates. However the true, long-term implications of the report and recommendations on our NHS may not be known for some time.