Responding to the Francis Report Putting Patients First

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Responding to the Francis Report Putting Patients First Evonne Harding Head of Clinical Governance/Lead

Responding to the Francis Report Putting Patients First Evonne Harding Head of Clinical Governance/Lead Nurse 11 th September 2013

Background & Timeline • Mid Staffordshire NHS Foundation Trust: • • • manages two

Background & Timeline • Mid Staffordshire NHS Foundation Trust: • • • manages two hospitals: Stafford Hospital & Cannock Chase Hospital provides healthcare for people in Stafford, Cannock, Rugeley and the surrounding areas, serving a local population of over 276, 500 people. • Appalling long term failure and suffering of many patients (2005 – 2009): HCC investigation brought scandal to light, high mortality rates among patients - Whistleblowing not acted on: Royal College Surgeons say dysfunctional surgical department - Financial recovery = staff cuts -FT: financial focus rather than quality - New Government announced new public inquiry, chaired by Robert Francis QC CHI 3 stars to zero stars 2004 2005/2006 2007 2008 2009 2010 2013 Final Report published Full scale investigation -Peer Reviews raised concerns about cancer & children’s services - HCC raised concerns re children’s services - Auditors reports identified deficiencies in risk management systems, - Staff & Patient surveys – worst 20% in country Andrew Burham announced further independent inquiry Wandsworth Clinical Commissioning Group 2

What went wrong? Organisational • Staffing Issues • Voice of People • Lack of

What went wrong? Organisational • Staffing Issues • Voice of People • Lack of Care • Data issues • Systems issues • Board issues Wandsworth Clinical Commissioning Group 3

What went wrong 2? Other Agencies Many Agencies failed to protect patients • PCT/SHA/Monitor

What went wrong 2? Other Agencies Many Agencies failed to protect patients • PCT/SHA/Monitor issues • HCC/CQC • Local MPs & GPs • Professional Regulation (RCN, NMC, GMC) • Others: Department of Health, Deanery/universities, HPA Wandsworth Clinical Commissioning Group 4

Overarching Recommendations Themes 290 Recommendations Fundamental culture & standards of behaviour change: Responsibility for,

Overarching Recommendations Themes 290 Recommendations Fundamental culture & standards of behaviour change: Responsibility for, & effectiveness 5 Immediate Pledges Immediate review by NHS Medical Director into 5 hospitals with high mortality rates*(Sir Bruce Keogh’s Overview Report) Patient, Public Involvement & Engagement and Local Scrutiny Nursing & Medical (training and education) Openness, Transparency and Candour Effective complaints and incidents handling Commissioning for Quality Joint Working & Leadership Information New role created of Chief Inspector of Hospitals Don Berwick brought in to make zero harm a reality in the NHS (Berwick Review into Patient Safety) Take advice on how hospitals should manage complaints Trust boards could be suspended for quality failures as well as losing control of the money Wandsworth Clinical Commissioning Group 5

Wandsworth CCG’s Mission Statement Better Care and a Healthier Future for Wandsworth Patient Focused

Wandsworth CCG’s Mission Statement Better Care and a Healthier Future for Wandsworth Patient Focused • Involving & Engaging patients • Supporting and Empowering them • Improvements in quality & range of services provided Outcomes Driven • Commission based on patient safety, clinical effectiveness, patient experience • local & national strategic priorities • Uphold NHS Consitution • Honesty & Integrity Principled • Thoughtful & Transparent • Responsible • Co-operation with members • Collaboration with partner Collaborative organisations • Co-ordinated and patient centred care • Responsible to our employees Progressive • Respect & value diversity & Professional • Encourage innovation and experiment with new ways • Celebrate successes Wandsworth Clinical Commissioning Group 6

CCG’s Framework for Action Approach Stage 1: Quality Programmes Stage 2: Patient & Public

CCG’s Framework for Action Approach Stage 1: Quality Programmes Stage 2: Patient & Public Engagement • Clinicians at the heart of commissioning: system addressing what matters most for patients • Quality Strategy: definition of quality, values based commissioning, quality alert systems: • Quality Assurance Framework: 4 stage methodology • Reflect & Gap Analysis against Francis recommendations • Partnership working with NTDA, LA, Healthwatch, NHSE, CQC • National Quality Reports discussed at IGC: Keogh, Berwick • Duty of candour proposal being discussed at IGC • Engage in South London Quality Surveillance Group meetings • Patients’ having access to information they want to make choices • Healthwatch strengthening their collective voice: close working with the CCG, patient feedback • Real-time to improve quality and timeliness of insight into patient experience (FFT, Enter & View, Commissioner walkabouts, etc) • Publish our Francis Framework for Action to demonstrate our acceptance of the recommendations & our intentions Wandsworth Clinical Commissioning Group 7