The Francis Report: one year on

This report explores how acute trusts are responding to the Francis Inquiry, one year on from Robert Francis QC’s original report into the failings in Mid Staffordshire hospitals.


Published: 06/02/2014

ISBN: 978-1-905030-77-4

Download the report [PDF 319.3KB]

Robert Francis QC talks about the impact of the Francis Report.

To mark the first anniversary of the publication of the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (the Francis Inquiry), the Nuffield Trust has published a new piece of research exploring its impact.

This study has been published to coincide with an event hosted by the Trust on 6 February 2014, exactly a year after the Francis Inquiry reported.

The study offers a snapshot into how acute trusts have responded to the Francis Inquiry Report. It is aimed at policy-makers, national statutory bodies, acute trusts, health representative groups and trade unions, patient groups and charities, and health service commissioners. Robert Francis QC, who acted as an adviser to the research, has written a foreword to the study.

It is reassuring to see that in large part the respondents to this research appear to have embraced the need to learn from the two inquiries into Stafford Robert Francis QC, commenting on the Nuffield Trust research

The research study found that many of the themes from the Francis Inquiry Report, including the importance of openness, adequate staffing levels and a patient-centred culture, have resonated with leaders of the hospitals responding to the survey and interviews.

Four in five of the hospitals responding to the online survey conducted as part of the research said they were taking new action in response to the report, and an even greater proportion said they already had work underway on many of the relevant recommendations when the report was published.

In interviews conducted as part of the research, senior NHS staff said that the 2013 Francis Report has added impetus to their efforts to put quality of care as their top priority, despite the straitened financial conditions facing the NHS. However, hospital leaders described how both meeting financial goals and ensuring safe staffing levels in hospitals was very difficult and would only get harder in the future.

Ruth Thorlby, lead author wrote in the study conclusion:

“Many of the themes and lessons from the Francis Report… were recognised by the hospital leaders in this study, who described their efforts to give greater weight to the quality and safety of patient care, and the underlying culture that drives quality.

"Nursing is receiving a significant degree of attention, in particular in staffing levels, the role of ward managers, and ensuring fundamental standards of care. Staff engagement is a higher priority than before, as is a renewed approach to the handling of patient complaints and the reporting of hospital performance.”

Robert Francis QC commented on the Nuffield Trust research, saying:

“It is reassuring to see that in large part the respondents to this research appear to have embraced the need to learn from the two inquiries into Stafford…there appears to be general acceptance that quality needs to be given a much greater priority.

“It is concerning, however, that some respondents reported that national bodies have persisted in some of the behaviours towards hospitals that evidently contributed to the problems identified by the two inquiries.

“If true, it would suggest that the lack of coordination and elements of the system-based culture so evident in the regulation and oversight of Mid Staffordshire have persisted in spite of the assertions to the contrary by the regulators. It is vital that national bodies exemplify in their own practice the change of cultural values which all seem to agree is needed in the NHS.”

Suggested citation

Thorlby R, Smith J, Dayan M and Williams S (2014) The Francis Report: one year on. Research report. Nuffield Trust.