By Vivienne Russell | 6 February 2013
Financial pressures are making it difficult for hospitals to implement many of the recommendations set out by the Francis inquiry into care failings, according to Nuffield Trust research.
One year on from the publication of the Robert Francis's landmark report on problems at Mid Staffordshire NHS Foundation Trust, the Nuffield Trust published the results of a series of interviews and surveys with senior staff and non-executives at a third of acute and foundation trusts across England.
These found that the Francis inquiry had been successful at putting patient experience and quality of care at the top of the priority agenda. However, it highlighted concerns that trusts might not be able to fulfil their ambitions in this area because of budget pressures and complex regulation.
One hospital chair quoted in the research said: ‘The one good thing Francis has done, the really good thing, is that is has ensured that safety and quality have become more prominent – that’s really important. But I am left with a real concern about the doability of it all and the need for us to find a way forward.’
But another leader told the researchers that care standards were more important to financial issues. ‘I’d rather be hung for money that for quality and safety,’ they said.
As well as financial stresses, the research also found that some hospital boards were finding it hard to meet increased demands for assurance and scrutiny from external regulators. These were described as burdensome requests and some suggested they distracted from a trust’s own efforts to develop their own quality-focused culture.
Commenting on the findings, Ruth Thorlby, lead author and senior fellow in health policy at the Nuffield Trust, said: ‘Many of the themes and recommendations of the Francis inquiry have been recognised by the staff we interviewed and the trusts taking part in this study appear to be making efforts to change their organisational culture, understand the quality of care and hear more clearly the views of staff and patients.
‘But many of the strategies being used to improve quality, such as boosting nursing numbers, are resource intensive and hospitals are also under huge financial pressures.’
Writing the foreword to the research, Francis himself said it was ‘concerning’ that, in some areas, regulators were alleged to be persisting in behaviours that contributed to problems identified by his inquiries into Mid Staffordshire.
‘If true, it would suggest that the lack of co-ordination and elements of the system-based culture so evident in the regulation and oversight of Mid Staffordshire have persisted in spite of the assertions to the contrary by the regulators,’ he said.
