“The Francis Inquiry report was clear that a closed culture, which instinctively concealed poor care rather than confronting it, lay behind the harm done to patients at Mid Staffordshire hospital. The emphasis on transparency which underlies these announcements is a welcome sign that the Government recognises this.
“We support the introduction of a duty of candour, which should put the law firmly behind the principle that concerns about patient care should always be reported and taken seriously.
Transparency will only work as a tool to improve care when it is clear who should be held to account for the outcomes it reveals Andy McKeon, Chief Executive, Nuffield Trust
“This response focuses strongly on new legislation and guidance to hospital trusts and their employees. Yet the Mid Staffordshire Public Inquiry was clear that change must include central bodies, commissioners and regulators.
“Policy-makers must ensure that these organisations understand their crucial roles in delivering safe and dignified care to patients, and create a culture that is open, supportive and patient-focused.
“The Government is right to emphasise staffing levels as an important factor underlying quality of care, without introducing overly simple or prescriptive national standards.
“Guidance given to providers and the public on staffing levels must always be based firmly on evidence and an acceptance that local factors have a role to play in determining the right level of staffing. The decision to seek guidelines from NICE is very welcome.
“Learning from and listening to patients and their communities will be crucial in helping the NHS to provide safer, better care. This response says little about engaging local people in conversations about quality of care. We hope the Government will make clear how it intends to support this in future.
“There is a risk that these new initiatives will have a centralising effect, taking responsibility and accountability away from the local bodies which have the ultimate duty to ensure proper standards are maintained. Transparency will only work as a tool to improve care when it is clear who should be held to account for the outcomes it reveals.
“As it implements these changes, the Government must communicate clear lines of responsibility, and balance its own role in holding the NHS to account with the need to avoid micro-management.”
Notes to editors
The Nuffield Trust is currently working with Robert Francis QC on a research project examining how NHS hospital trusts and foundation trusts are responding to the Mid Staffordshire Hospital Public Inquiry. A report of this work will be published in February 2014, one year on from the Inquiry’s publication.