Doctors must have power to speak out, Francis tells MPs
13 February 2013
Doctors must be empowered to speak up about patient safety concerns, MPs were told yesterday.
The chair of the Mid Staffordshire NHS Foundation Trust public inquiry said he hoped his recommendations would encourage more openness about mistakes and a willingness to whistleblow where necessary.
Robert Francis QC was appearing before the Commons health select committee as it examines his inquiry report, which was published last week.
Introducing a statutory ‘duty of candour’ to make NHS staff legally bound to report safety concerns was one of his report’s 290 recommendations.
He told MPs: ‘I want this to ensure that those who are responsible professionally, [on] the frontline, are not left with nothing to do [in reporting concerns]. I want to see them empowered and encouraged to express a view.’
He said he wanted encouragement for NHS staff to say to their colleagues: ‘I’m terribly sorry. I had to [report this concern] because otherwise I could be prosecuted.’
Fundamental standards
The events at the Mid Staffordshire trust had seen a ‘tsunami of anger’ directed towards the NHS, he said.
Mr Francis also said he hoped regulators would share information about the performance of hospitals and trusts more effectively with each other.
He added that this could ‘lead quite quickly to a professional regulator being able to identify individuals who would need their attention.’
Mr Francis elaborated on the fundamental standards that he recommended should be introduced in the NHS. Such standards included basic care, such as access to necessary medication, water, food and cleanliness, but could include staffing levels, he said.
He also gave more details on what he anticipated should be the role of NHS commissioners in safeguarding care standards.
Mr Francis said commissioners should be ensuring that the services they were commissioning from NHS trusts were being delivered to the standards set out in their service specifications.
NHS management should have similar ethical standards as doctors working in the NHS, Mr Francis said.
Patient involvement
MPs were told of the need for patients to be asked for their feedback on the care they received in hospital.
Mr Francis also said he wanted patients to be able to look up infection rates on the ward where they would stay, and the mortality rates of the surgeons who would operate on them.
However, he accepted that better information technology systems were required for this.
MPs quizzed Mr Francis on why his report had not called for the resignations of individuals at either the trust or at higher NHS management levels.
Mr Francis said: ‘It’s not for an inquiry [chair] to say what people should do following an inquiry. It’s for them and the people who employ them to consider the report.’
NHS chief executive Sir David Nicholson, who has been heavily criticised by the families of patients who died or experienced poor care at the trust between 2005 and 2009, will appear before the committee on March 5.