Our response to Francis
In February 2013, the second Francis report was published setting out the findings arising out of the public inquiry into the role of the commissioning, supervisory and regulatory bodies in the monitoring of Mid Staffordshire NHS Foundation Trust.
The Report called for action across six core themes around culture, compassionate care, leadership, standards, information, and openness, transparency and candour. The Government’s initial response, Patients First and Foremost, set out a plan to prioritise care, improve transparency and ensure that, where poor care is detected, there is clear action and clear accountability.
In November 2013 the Government published ‘Hard truths – the journey to putting patients first’ which provides a detailed response to the 290 recommendations across every level of the system. It also responds to six independent reviews which the Government commissioned to consider some of the key issues identified by the Inquiry.
The Trust has scrutinised the findings of the second Francis Report to ensure that it has taken and that it continues to take appropriate action in light of the recommendations with quality and safety being the primary consideration.
As Steven Michael, Trust Chief Executive explains,
“Quality underpins everything we do in our Trust and we do all we can to ensure that people who come into contact with our services have the best experience of care. Our Trust strives to create a culture of respect, compassion, quality and safety and our Board continually seeks assurance that this is happening.” Steven adds, “We have considered the implications of the Francis Report and how they apply to the Trust, particularly where we need to do further work relating to the recommendations. We have approached this in a balanced and measured way to make sure we provide the best possible response.”
The Trust’s Board, through all its discussions, is mindful of the Francis findings with Chair, Ian Black, stating that
“People who use our services are at the heart of everything we do and the drive for continuous improvement is our top priority. This drive starts at the top of our organisation with our Board. The work the Trust has done to review and respond to the recommendations in the Francis Report will support us in providing the best services we possibly can for the local communities we serve”.
How have we implemented the Francis recommendations?
In May 2013 the Trust reviewed its processes and considered the implications of each recommendation to reach an informed judgement of the Trust’s position and identify any existing areas of work where action required could be placed. This was followed by a focused review by both the Executive Management Team and Trust Board.
This review was supported by workshops involving a cross-section of staff from all services and in different roles. The workshops particularly focused on the recommendations related to training and education, openness, transparency and candour, nursing (expanded to look across all professional groups), care for the elderly and common information practices. The Trust recognises the need for staff to continue to be aware and engaged in the organisation’s response and further staff learning events are being planned to ensure that the Trust maintains and builds on the communication and feedback.
The Members’ Council has also considered the recommendations, in particular, those relating to the role and responsibilities of governors. It is important that the Trust’s governors have the knowledge to understand the organisation and their accountabilities and, to support this, there is a continuous development programme in place, which is reviewed and updated annually. A Members’ Council Quality Group has also been established looking specifically at the Trust’s Quality Framework and the quality priorities, which are reported in our Quality Account.
Our strong customer services ethos means that the Trust tries to ensure the service user voice influences all it does.
Since the Francis Report was published, the Trust has held listening events with service users, their carers and members of the public. The listening events have been linked to the mission and values and the service transformation programme and the strong themes that have emerged provides directio for the future of our services. Within the context of the Francis Report, we have re-framed our values and have defined our twelve personal standards for care and support planning, and twelve personal standards for reviews of care. A Carers’ Charter is also close to completion.
The Trust continues to focus on ways of receiving and acting on service user feedback about their experience of care. The Trust works hard to ensure that complaints processes and responses to any complaints are dealt with sensitively and effectively in a timely manner. Use of technology to support real-time service user feedback is well advanced with all in-patient areas completing regular surveys and the use of technology in community services is progressing.
Throughout 2013/14, the Trust has introduced new values-based recruitment, induction and appraisal processes to support the fundamental requirement for compassionate care and to ensure our staff are fit and well to care. In 2014/15, The Trust is planning a ‘Year of Values’, including the roll-out of more ‘right first time, every time’ customer service modules, which will reach about 150 staff each month. The Trust is also building on processes for developing skills in local resolution of concerns and staff being empowered to challenge poor behaviour.
The next stage is for the Trust to review the implications of ‘Hard Truths’ and ensure the response is incorporated within the organisational action plan.
If you would like further information on the Trust’s approach and its response to Francis, please contact customer.services@swyt.nhs.uk