Regulation and oversight of NHS trusts after the Francis report

Abstract

The report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, led by Robert Francis QC and published on 6 February 2013 (Francis, 2013), contains a damning account of the failure of the NHS regulatory regime to pick up on the conditions of appalling care that existed in the Mid Staffordshire NHS Foundation Trust between 2005 and 2009. In the foreword to the Government’s initial response to the Francis report (DH, 2013a), the Secretary of State for Health, Jeremy Hunt MP, does not mince his words: “The report of the Mid Staffordshire NHS Foundation Trust Public Inquiry makes horrifying reading. At every level, individuals and organisations let down the patients and families that they were there to care for and protect. A toxic culture was allowed to develop unchecked, which fostered the normalisation of cruelty and the victimisation of those brave enough to speak up. For far too long, warning signs were not seen, or ignored or dismissed. Regulators, commissioners, the Strategic Health Authority, the professional bodies and the Department of Health did not identify problems early enough, or, when they were clear, take swift action to tackle poor care. They failed to act together in the interests of patients. This was a systemic failure of the most shocking kind, and a betrayal of the core values of the health service as set out in the NHS Constitution. We must never allow this to happen again.” The joint policy statement of the DH, CQC, NHS England, Monitor and the TDA (DH, 2013b) (the policy statement) accompanies the Care Bill introduced to Parliament on 9 May 2013. It contains measures that are designed to ensure that the horrific failings identified in the Francis report never happen again. The policy statement sets out a number of significant changes that will be made to the regulation and oversight of NHS hospitals, setting out the new NHS Trust regulatory landscape after Francis.