No. Recommendation Hard Truths Government response ... No. Recommendation Hard Truths Government response

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  • . No. Recommendation Hard Truths Government response Progress update 1 It is recommended that:

    • All commissioning, service provision regulatory

    and ancillary organisations in healthcare should consider the findings and recommendations of this report and decide how to apply them to their own work;

    • Each such organisation should announce at the earliest practicable time its decision on the extent to which it accepts the recommendations and what it intends to do to implement those accepted, and thereafter, on a regular basis but not less than once a year, publish in a report information regarding its progress in relation to its planned actions;

    • In addition to taking such steps for itself, the Department of Health should collate information about the decisions and actions generally and publish on a regular basis but not less than once a year the progress reported by other organisations;

    • The House of Commons Select Committee on Health should be invited to consider incorporating into its reviews of the performance of organisations accountable to Parliament a review of the decisions and actions they have taken with regard to the recommendations in this report.

    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 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 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.

    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.

    2 The NHS and all who work for it must adopt and demonstrate a shared culture in which the patient is the priority in everything done. This requires:

    • A common set of shared core values and

    standards shared throughout the system. • Leadership at all levels from ward to the

    top of the Department of Health, committed to and capable of involving all staff with those values and standards;

    Accepted. Shared core values and standards:

    • We will continue to use and promote the core values and expectations for the

    NHS set out in the NHS Constitution. • The development of values based recruitment by Health Education England

    will reinforce the importance of values as the driving force of the NHS. • The Care Quality Commission has conducted a major consultation on a new

    set of fundamental standards of care which will set out the inviolable principles of safe, effective and compassionate care that must underpin all care in the future.

    The Department of Health has put in place a number of measures to address the elements of this recommendation. The detail of what the Department of Health have done is set out in the report on progress ‘Culture Change in the NHS - Applying the Lessons of the Francis Inquiry’ and in the updates we have provided on progress against other recommendations made by Sir Robert Francis QC. Among those measures are: Shared core values and standards

    • The Department of Health is consulting on a number of measures in relation to the NHS Constitution in response to the recommendations

    https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170701/Patients_First_and_Foremost.pdf https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/270368/34658_Cm_8777_Vol_1_accessible.pdf http://www.publications.parliament.uk/pa/cm201314/cmselect/cmhealth/657/657.pdf http://www.publications.parliament.uk/pa/cm201314/cmselect/cmhealth/657/657.pdf https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/270368/34658_Cm_8777_Vol_1_accessible.pdf

  • • A system which recognises and applies the values of transparency, honesty and candour;

    • Freely available, useful, reliable and full

    information on attainment of the values and standards;

    • A tool or methodology such as a cultural

    barometer to measure the cultural health of all parts of the system.

    • The introduction of a new and robust inspection regime is an important

    shift in the way nationally the system will ensure poor care is identified and tackled.

    Leadership at all levels

    • We recognise the importance of leadership at all levels in ensuring that we

    prevent terrible failures of care of the kind we saw at Mid Staffordshire NHS Foundation Trust, and welcome the connection made in this recommendation between effective leadership and the engagement of staff.

    • The NHS Leadership Academy is developing and implementing a wide

    ranging programme of leadership support at all levels of the NHS, with a strong emphasis on values.

    Information on the attainment of the values and standards

    • We agree that the NHS needs to do much more to put in place a

    transparent approach to providing care and to working with patients. The shift to greater transparency is the foundation for the culture of honesty and candour that this recommendation calls for.

    • We are putting in place legal changes that place a statutory duty of candour

    on healthcare providers and which create a new offence of providing false or misleading information.

    Measuring cultural health

    • We agree that it is important to ensure there is a clear understanding of the

    cultural health of different parts of the NHS. Regular inspection will provide the basis for a new, clear, transparent system of ratings that will be accessible to the public. All acute hospitals in England will have been inspected by the end of 2015.

    • The Care Quality Commission is developing a set of indicators for inspecting

    all providers of NHS care, and this will permit judgements to be made about the culture of the organisation in question as well as other elements of its performance.

    • In June 2013, the Care Quality Commission issued A new start –

    Consultation on changes to the way CQC regulates, inspects and monitors care. In this, the Care Quality Commission suggested that a ‘well-led’ service is one where there is effective leadership, governance (clinical and corporate) and clinical involvement at all levels of the organisation, and an open, fair and transparent culture that listens