Francis Inquiry

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The Francis report provided a detailed analysis of what contributed to serious failures in care at Mid Staffordshire NHS Foundation Trust. 

Led by Robert Francis QC, the landmark report, published in February 2013, identified how the regulatory and oversight system failed to detect and address the trust's problems. It concluded that what happened at the trust was the result of a system failure, as well as a failure of the organisation. It called for a fundamental change in culture across the NHS.

The report's  findings and recommendations have shaped health and care policy and renewed the health service's focus on delivering the highest possible care for patients.

Changing culture

The government's response, issued in November 2013, accepted most of Robert Francis' 290 recommendations and outlined a number of measures to ensure patient safety and high-quality care. The government announced:

  • regular publication of patient safety data
  • a statutory duty of candour on organisations and professional duty on individuals
  • greater senior involvement in complaints handling
  • guidance and tools for setting staffing levels and regular publication of actual levels
  • fit and proper persons test for board members and greater performance management of very senior managers
  • a new offence of wilful neglect, applicable to individuals and to organisations
  • a 'Clinical Bureaucracy Index' for trusts and Concordat between national bodies to reduce bureaucracy.

The government and regulators are responding to the quality challenge raised in the report through a series of new legal measures.


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Post-Francis independent reviews

In the wake of the Francis report, the Government commissioned six independent reviews to consider several of the key issues identified by the inquiry.

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Background to the inquiry

Our interactive guide provides a detailed overview of what led to Robert Francis QC's inquiry.

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Progress post-Francis

Find out how the NHS Confederation and NHS Employers organisation have been supporting members to implement the changes ushered in by the Francis report and 'Hard truths'.

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The announcement by the Secretary of State of a raft of measures designed to improve the mental health of NHS staff is an important and welcome one. It is a first step in the NHS making good on the NHS Ten Year Plan's desire to see employers having "a key role to play in supporting their staff to stay well and in work.” Given the higher than average sickness rates in the NHS compared to other public sector organisations, Peter Molyneux, chair of Sussex Partnership NHS Foundation Trust, explains why it is important that the NHS sets the standard.

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