The Francis Report

The publication of the Francis report yesterday was a sobering moment for anyone who works in healthcare. The systematic lack of care described in Stafford Hospital makes gruelling reading. What makes it worse, if we are honest, is that we all know that instances of poor care sometimes take place in our own hospitals, even if they do not reach the epidemic proportions described in the report. How could this happen? Francis identifies a number of causes. Now I have read the report, these seem to me to be three important issues:

Firstly, the danger of focusing on the anything other than the needs of patients. Any director, nurse, doctor, therapist or manager who forgets that, first and foremost, they are there to serve patients is on a slippery slope. And if the board fails to make quality of care its first priority, there can be little surprise if staff become disengaged from organisational priorities. Some people who worked in the Mid Staffordshire Trust lost sight of the needs of its most vulnerable patients, especially older people.

Secondly, we should not tolerate poor standards and risk to patients. It must be right, however much tension it might cause between us from time to time, that we challenge each other to provide a proper standard of care. That is a sign of a healthy organisation. We should also aim for excellence in our care processes. A certain amount of data recording and measurement will always be necessary to make sure we're doing the right things, and we also need to be careful to communicate information properly when we hand over patient care. But we should have a low tolerance for care processes which are wasteful, or cause unnecessary waiting or repetitive collection of the same data.

And thirdly, there is a professional challenge to make sure that we create a positive culture in our healthcare organisation. The challenge to show proper leadership, and followership, is one we must all rise to. We must all make sure that the organisation we work in is open in allowing concerns to be raised freely; transparent in showing how well, or badly, it is doing; and candid in telling people when we have got things wrong.