Mid Staffordshire NHS Inquiry Report - Key points: Leadership, Culture and Corporate Governance
In his introduction to the report Robert Francis QC makes the point that the failure at Mid Staffordshire was “primarily caused by a serious failure on the part of a provider Trust Board. It did not listen sufficiently to its patients and staff or ensure the correction of deficiencies brought to the Trust’s attention. Above all, it failed to tackle an insidious negative culture involving a tolerance of poor standards and a disengagement from managerial and leadership responsibilities.”
The buck stops with the Board, and some of the wide-ranging recommendations set out in the report will have a direct impact on Board composition, conduct and performance.
The key messages are:
Much of this is perhaps already part of the way in which good Boards operate, but the impact of the report will be to turn much of what is currently good practice into obligations. It remains to be seen though whether the increased emphasis on obligations and criminal offences will have the desired effect of improving the culture of the NHS. There will of course also be additional costs in ensuring compliance with the requirements.
There is however a further problem. The report
acknowledges that the NHS has to operate within available
resources, but does not address the potential problems that this
can cause either at provider level or more widely. Clearly,
as the report articulates, if a service does not meet fundamental
standards it should not be provided. But where does that
leave the patient if the result is a denial of a service?
More seriously if the Board prudentially takes the view that a
particular service is not capable of being provided at the
acceptable levels for the tariff price this will need to feed into
negotiations around price variation, and potentially passes the
financial issue back to the commissioners.
In the coming weeks Bevan Brittan is hosting a series of
seminars across its offices to consider the implications of the
Inquiry more fully. Following these we will issue more detailed
briefings on what the Inquiry's conclusions mean for different
players in the system. The scheduled dates for these seminars are
Bristol: 20 February 2013 Birmingham: 26 February 2013 London: 1 March 2013
Please click on the above dates and locations to view further details and to register for the seminars.