Charities demand urgent steps to prevent another Mid Staffordshire scandal

BMJ 2012; 345 doi: (Published 16 October 2012) Cite this as: BMJ 2012;345:e6956
  1. Adrian O’Dowd
  1. 1London

A coalition of 150 health and social care charities has called for urgent action to prevent another scandal like that at Mid Staffordshire NHS Foundation Trust from happening.

The coalition, National Voices, published a report on 15 October to coincide with the planned publication date of Robert Francis QC’s second report into failures at the trust.1 That report has now been delayed until January next year.

The whole process of investigation and inquiry into the trust had taken too long, and NHS planners were continuing to “wait for further instructions” when they should have been taking steps to improve the safety and care of patients, said the charities. These steps are urgently needed across the whole of the NHS in England, they said.

Former investigations and inquiries found at least 400 excess deaths at one of the trust’s hospitals between 2005 and 2009, and “appalling” standards of care were detailed in a final report by the former NHS watchdog the Healthcare Commission.2

National Voices’ report, Not the Francis Report, said that there could be another Mid Staffordshire-like scandal because of the slowness in change throughout the NHS.

Robert Francis’s public inquiry has had a paralysing effect on improvements to safety and the quality of care, said the report, which argues that there is no reason for further delay in learning the lessons from Mid Staffordshire.

“The NHS is under stress,” says the report. “Demand is rising as the population of people with chronic conditions and disabilities grows. Funding is not keeping pace with demand. The major reorganisation of the structures of the NHS is inevitably distracting time and attention from front-line care.”

It recommends a concerted drive by NHS organisations to involve and listen to patients and carers. It says that the law needs to change to create a “statutory duty of candour” to overcome “a long-standing and persistent culture of secrecy, cover-up and authoritarian management in the NHS.”

It also calls for implementation of the Dilnot reforms as a necessary first step for ensuring enough funding for social care. In his independent review on the funding of social care for adults in England, the economist Andrew Dilnot recommended a cap of £35 000 (€43 000; $56 000) on the contribution that any person made for care during his or her lifetime, beyond which he or she would be eligible for full state support.3

Urgent work was needed to ensure that the safety and quality of care in hospitals did not vary with a patient’s age and time and day of admission,4 said the authors, who described the current variability in services as “unethical and scandalous.”

National Voices’ chief executive, Jeremy Taylor, said, “There needs to be a much greater sense of urgency in implementing much needed improvements in the NHS if we are to prevent a repeat of the failings at Mid Staffs.

“It is three years since failures in Mid Staffordshire came to light. The second Francis report has been delayed twice, yet that shouldn’t stop us learning the lessons from Mid Staffs and other places.

“We already know what to do. There is no shortage of evidence to underpin improvements. However, what seems to be lacking is any sense of urgency to get things done on a system-wide basis.”


Cite this as: BMJ 2012;345:e6956


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