Implementing the recommendations

Accepted.
The Inquiry made recommendations aimed at national organisations both by name and by implication because of the nature of their responsibilities within the newly reformed system. This document includes a detailed account from each of these organisations on what they have already done to implement recommendations directed to them and what further action they plan to take. Many organisations have published updates separately on their own websites.
In addition, a number of recommendations were aimed at NHS Trusts and NHS Foundation Trusts.
The Secretary of State wrote to all Trust Chairs in February 2013 asking them to hold listening events with their staff to hear what they have learnt from the Inquiry findings, and how they best think safe, effective and compassionate care can be delivered in an NHS managing a growing workload within a tight financial context. He followed this up with a letter on 26 March asking them to set out how they intend to respond to the Inquiry’s conclusions before the end of 2013. Some Trusts have already issued a response. We would expect these responses to be placed on Trust websites. To maintain momentum, we would encourage all NHS trusts and NHS Foundation Trusts to use the opportunity this further response to the Inquiry presents to continue these local conversations. Leadership teams that put patients first recognise their organisations rely on the skill, motivation and behaviour of the people providing care to patients to drive improvements in safety, quality and compassionate care.
The Government’s initial response to the Inquiry, Patients First and Foremost published in March 2013, set out a radical programme to prioritise care, improve transparency and ensure that where poor care is detected there is clear action and clear accountability. Informed by the six independent reviews and more detailed work over the summer, Hard Truths: the the Journey to Putting Patients First builds on this to provide a detailed response to each of the 290 recommendations made by the Inquiry. The Department of Health will lead the system in providing an annual report on progress each Autumn.
The Health Select Committee confirmed in its 3rd Report After Francis – making a difference, published in September 2013, that it agrees with the Inquiry’s recommendation that it should monitor implementation of all his recommendations. Specifically, the Committee proposes to enhance its scrutiny of regulation of healthcare professionals by taking public evidence each year from the Professional Standards Authority for Health and Social Care on the regulatory environment and the performance of each professional regulator, based on the Professional Standards Authority’s own performance reviews. The Government is publishing its response to the Health Select Committee’s report in parallel with Hard Truths.

The Thirlwall Inquiry has noted action taken in response to this recommendation following the conclusion of the Mid-Staffordshire Inquiry 2013.

The Government and other relevant organisations published a series of reports responding to each recommendation made by the Inquiry, subsequently updating on progress against them.

Monitor’s Quality Governance Framework (2013) specifically referenced the Francis Report and highlighted the importance to boards of using insights gathered from external reviews across the NHS, asking the question "Could that happen here?"

Hard Truths: the Journey to Putting Patients First published in November 2013 provided an integrated and detailed response to each of the 290 recommendations made by the Inquiry from every part of the health and care system. As part of the Department of Health’s commitment to leading the system in providing an annual progress report, this document sets out what progress has been made towards implementing the actions set out in Hard Truths for each recommendation over the last year.

The Department of Health know that local conversations in NHS Foundation Trusts and NHS trusts on the learning from Francis have continued throughout the year with the focus increasingly shifting towards on driving further improvements in safety, quality and compassionate care across all health and care sectors and settings.

This recommendation was accepted by the Government.

Below are the publicly available reports from various relevant organisations concerning their response to the Inquiry and its recommendations.

Central Government

The Government published its initial response in March 2013.

In January 2014, the Government published a two-volume report titled “Hard Truths: The Journey to Putting Patients First” responding to each recommendation made by the Inquiry.

In February 2015, the Government published a further report, titled “Culture Change in the NHS: Applying the lessons of the Francis Inquiries”, which provided a progress update in relation to each recommendation made by the Inquiry.

The government also commissioned six review groups to explore some of the issues raised by the Inquiry, namely the Keogh Review, the Berwick Report, the Cavendish Review, the Clwyd-Hart Review, the NHS Confederation review of the NHS hospitals’ complaints system and the Children and Young People’s Health Outcomes Forum Report.

NHS England

By a Board Paper dated September 2013, NHS England set out details of progress against the recommendations made by the Inquiry for which it considered itself the lead organisation. In February 2014, NHS England published a 1-year-on news release, summarising improvements made in the previous year.

The NHS Commissioning Board

The NHS Commissioning Board published an initial press release in February 2013 following publication of the Inquiry’s report.

The Care Quality Commission (CQC)

The Care Quality Commission published online news releases in February 2013 and February 2015 announcing respectively what it intended to do and what progress it had made in implementing the recommendations of the Inquiry.

Monitor

Monitor published a statement on 26 March 2013 in relation to the initial government response to the Inquiry.

Healthwatch England

Healthwatch England published an initial response to the recommendations of the Inquiry dated 26 March 2013.

The Health and Care Professions Council

The Health and Care Professions Council considered a paper from its executive in March 2013 and a further paper in May 2013 which contained its policy statement An update was published in July 2014.

The General Medical Council

The General Medical Council published an initial response, which is undated.

A 6-month update was published in October 2013. A further update was published in April 2014. A third and final update was published in October 2014.

The Nursing and Midwifery Council

The Nursing and Midwifery Council published a formal response in July 2013. In March 2014, the Nursing and Midwifery Council published an update report.

Royal Colleges

The Royal College of Surgeons published a response in March 2013.

The Royal College of Nursing published a response to the Inquiry in July 2013.

The Royal College of Physicians published a response to the Inquiry in September 2013

The Health Select Committee

The Health Select Committee agreed to monitor implementations of recommendations and to enhance scrutiny of regulation of healthcare professionals by taking public evidence each year from the Professional Standards Authority for Health and Social Care on the regulatory environment and performance of each professional regulator. The Select Committee published a report “After Francis: making a difference” in September 2013.