How much will Mid Staffordshire Public Inquiry change things?

Abstract

The dust is finally beginning to settle following the Government’s response to the Francis report, and we are beginning to see what is actually going to change as a result. A few things still need to be bottomed out of course – not least the question of whether England introduces a full statutory Duty of Candour or some pale shadow of it, which could actually make things worse. This was discussed in some detail in a previous issue. At the time of writing, an announcement has yet to be made about this. However, whilst we eagerly await the Government’s decision – arguably the most central and important potential outcome from the inquiry – some things are becoming clearer. The Government has made much of accepting the ‘vast majority’ of Francis’ recommendations. However, a closer look shows that many of these are accepted ‘in principle’, but the Government is actually going to do something rather different from what was recommended, if anything at all. Perhaps, the most noticeable changes have come in the approach to regulation, the need for which was so graphically exposed by the inquiry. Whilst some of the details of the recommendations such as merger of Monitor with the Care Quality Commission (CQC) were not accepted, the main thrust at least was taken to heart. We are already beginning to see a completely different approach from the CQC. A beefed-up inspection regime; a willingness to engage with and act on intelligence from patients and whistleblowers; and a much more open and principled style of leadership. Some of the disappointments were the refusal to accept recommendations about introducing guidance on minimum staffing levels or to bring in regulation of healthcare assistants. These are decisions which I fear may come back to haunt ministers. Questions about staffing levels and skill mix, and indeed the effect of 12-hour shift patterns are, I fear, going to remain a huge issue. Even more so due to the strain on resources. The issues are commonly a red hot topic of debate in Wales, which has been facing its own Stafford-style scandals. More of that later. Action against Medical Accidents (AvMA)