Thursday, 7 February 2013

The Francis Inquiry

I listened with horror to the details of the Francis Inquiry into the 400 to 1,200 extra deaths at Stafford Hospital due to failures in care. The inquiry appears to have been very thorough, and has exposed failings that strike at the heart of the NHS. Sadly, I have family for whom Stafford is their nearest hospital, and who have their own tales of its institutional failings.

After the publication of the report yesterday, politicians of all parties gave speeches about how terrible the events were, and how we should learn the lessons. Despite their fine and predictable words, I have more than a few doubts that anything will change. For on thing, many of the recommendations have been outlined in previous inquiries into failures in the NHS.

The solution? Politicians need to start acting like engineers.

It's quite simple. Give each of the 290 recommendations from the Francis inquiry a number. For each one, the government gives a detailed response within a month. This response can vary from 'already done' through 'planned', to 'not doing', although in more detail.

Then there is a publicly-visible website with each recommendation having a different section. This shows progress towards the fulfilment of each recommendation, and is updated regularly.

For example, take recommendation 204:
All healthcare providers and commissioning organisations should be required to have at least one executive director who is a registered nurse, and should be encouraged to consider recruiting nurses as non-executive directors.
On the face of it, this seems an eminently sensible and easy change. In an initial response, the government should say whether they agree that this change is needed. If so, then a plan should be set in place to ensure that it is met. This could be something like:
  1. All healthcare providers and commissioning organisations should give details of the current status with respect to this recommendation.
  2. The government sets a deadline for this to occur; for instance a year.
  3. By the deadline, each organisation gives an update, saying whether they have met the target. This is publicly available, so the public can see if their provider has met the recommendation.
Openness is key. Anything else allows the recommendations to be forgotten and for it all to happen again in a few years.

The recommendations can be found in Volume 3 at

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