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Francis Report: Royal College of Surgeons’ reaction

The catalogue of neglect, squalid bedside humiliation and unnecessary deaths are beyond comprehension to those of us who came into the NHS to care for patients and make them better. I’m profoundly sorry for what those patients and their families went through and that they bore such abysmal treatment at the hands of healthcare staff.

We welcome today’s publication for highlighting, the wider issues of leadership, compassion and the delivery of safe care. Robert Francis QC has carried out a forensic examination of the systemic problems which could have given rise to such atrocious neglect. The proposal of a set of fundamental standards to underpin the delivery of high-quality care, defined by what patients want and influenced by the expertise of the Royal Colleges, will act as a catalyst  to improve care.

We know that a number of factors came together at Mid Staffordshire NHS Trust which created a perfect storm of neglect. It is now vital that the NHS moves forward, and shows its determination to focus on driving through quality – not just paying lip service to it – across all hospitals.

We believe that trust and openness between staff lies at the heart of all good healthcare. As the body responsible for setting surgical standards, we know that raising concerns early, before they become a serious patient safety threat, combined with a strong relationship between clinicians and managers, is vital to patient safety.

Since Mid Staffordshire, we have significantly strengthened our Invited Review Mechanism, a service the College provides to a Trust that wants independent advice on any surgical concerns it has. This early form of peer review can help resolve problems before they become insurmountable, and helps hospitals improve team performance and avoid harm to patients.

We are now preparing for the publication of surgeons’ results later this year and welcome the report’s commitment to the publication of proper outcome data which is publically funded. The surgical profession believes this will help reduce mortality rates through greater scrutiny, drive down poor performance and ultimately empower patients.

But there is still a long way to go. We are still concerned about a zealous pursuit of targets in some trusts to the detriment of quality of care, particularly around the focus on elective procedures in preference to urgent or emergency work. There is also fragmentation of care, as patients will sometimes see four or five doctors in a day due to the rules on working hours and shift patterns.  We look forward to the government helping to overcome this issue and ensure that there is greater continuity of care and less disruption.

These matters must be rectified if we are to cement a culture of exemplary clinical practice within our health service and put patients at the heart of all we do.

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