It's a hot topic that is coming up in Midwifery Interviews at the moment; the Francis report and recommendations. I was having a chat with someone on a forum who is interviewing today (14th April 2014), and she was worried about how to address the topic.
I can understand why - it's obviously very important to have good knowledge of what the report was and what it means for midwives. However it's been dragged out messily in the press since 2000, and there are 290 suggestions to improve UK healthcare in the report.
It's also terribly distressing for healthcare professionals, as we care so much about patients and can't understand what went wrong. It reflects badly on all of us.
The whole case is a mess, it's hard to understand, and even harder to answer an interview question on it in a way that will impress interviewers.
To help, here's a summary of what went on:
The origins of the Francis report started off in Stafford, all the way back in 2000. There was a lady (Julie Bailey) whose mum died in Stafford hospital who started campaigning to get the NHS back on track. It became a big story in the press, and a big concern because the hospital in question had high mortality (death) rates compared with other hospitals.
The Healthcare Commission, which was the government organisation designed to make healthcare better at the time, found things were going wrong with the hospital big time stylies, on lots of levels. There were awful reports of patients having to drink water from flower vases because they couldn't get to water, or were left in their own urine, that kind of thing.
As an aside here, it's useful to know the 'Healthcare Commission' has turned into the 'Care Quality Commission' - and this year this commission has been criticised really badly, with 30 families who have been chronically neglected, and the guy in charge, the Secretary of State admitting 'It's not fit for purpose'.
With me so far? In summary, a hospital in Stafford got in trouble for high mortality rates, a government body tried to address things, but now the government body is coming under criticism as well.
Basically the Francis report came up with 290 recommendations for UK hospitals including:
- Better staffing, looking at a ward by ward basis; obviously a good thing for midwives (if it works!)
- Patient safety fellows to be put into hospitals (to be trained and to champion good care)
- If patients are neglected it will be a criminal offence as opposed to just being a disciplinary one
- A new care certificate will be mandatory for Health Care Assistants so they can be regulated better
- Nurse and Midwives will be allowed to whistleblow without getting into trouble with managers
This all sounds pretty good, and will hopefully improve patient care --- but, we're always trying things like this in government, there might not be that big of an improvement.
So, you should be able to craft your interview answer from these details. Here is how I would answer a question on the Francis Report:
Question: How do you think the Francis report will affect care in the future?
'It's awful so many people died or were given substandard care. It's really difficult to know exactly what went on in the hospital at the time, I think there were staffing issues and other big problems. I think i'd need to do a lot more research before judging any of the staff in that hospital - but it does motivate me to want to give really excellent care from the heart, and it also appears to be a good thing that reporting substandard care will be easier and the government is looking at staffing.
Obviously this is a really complex situation. I know the Royal College of Midwives approved of the protection for whistleblowers... but also it is slightly worrying the Government is making neglecting patients a Criminal Offence.
After all, it doesn't sound like entirely the Stafford Hospital staff's fault - although I take accountability very seriously, and always try to look after the women in my care in a way that I would want my sister or mother to be treated.'
Do you have anything to add to this information? I'd love to hear from you. And remember, if a friend or colleague is interviewing soon, Sharing is Caring, use the share buttons below 🙂
So did the 6 c’s come about as a result of this report? I was thinking this but cannot seem to find a direct connection now? Confused
Yes, that’s right Rachel, it did prompt the 6Cs. You can see more on this here: http://www.nhscareers.nhs.uk/promotions/implications-of-the-francis-report/ I hope this helps! x
Thanks Ellie yes I have found Jane Cummings compassion in practice now Francis report was one of many she used to support Her development of 6 c’s
Hi Ellie,
How have things progressed since you wrote this article? Have the government actually lived up to its word and is the NHS actually better thanks the report?
Hi Emma, that’s a massive question and hard to say. I’m at the moment reading the Morecambe Bay report, which makes me feel sad and view that in some areas we’ve still got a long way to go. The most recent Confidential Enquiry that looked at maternal mortality (MBRRACE) was really encouraging in that mortality has gone down, even in these difficult and short staffed times. I’d say the vast majority of trusts are doing really well and taking everything on board, and the majority of midwives want to offer fantastic care. But some trusts are making grave errors and letting the atmosphere become toxic.
Thanks for your reply- I’ll have a look at these reports.
I’ve got my first interview next week for a midwifery degree, and I just wanted to say thank you for your wonderful website! I’ve taken in so much information and I’m now going through your youtube channel. It’s all very interesting and you’ve been such a useful resource, so, thank you!
Emma
Thanks so much for letting me know Emma, good luck with your interview!
Are the 6 Cs mentioned above like the 10 Care Qualities you learn about in Health & Social Care?
Hi – the 6Cs are part of a national nursing strategy and were developed by the UK Chief Nursing Officer in response to the Staffordshire failings and other incidents. The values are care, compassion, competence, communication, courage and commitment, and should be embraced by every healthcare professional. I’m not sure about the 10 care qualities, this sounds more about the academic study of how care is given?
Hi Ellie,
Thanks for your wonderful website, it has given me so much info. You say above about the Francis report prompting the 6cs. Did the kirkup report then prompt the code, or was that already there? If not, did it prompt anything new other then Mbrrace?
Thanks!
Hi Leigh,
So glad to hear the resources are helping!
The code has been around for a very long time, at least back to the previous incarnation of the Nursing and Midwifery Council which was the UKCC. It gets updated every few years.
The Kirkup report (about Morecambe Bay failings) was one of the things that prompted revalidation, which you can see more about here: https://www.rcm.org.uk/watch-our-revalidation-video
MBRRACE is a confidential Enquiry into Maternal Deaths in the UK which you can read more about here – the UK has the longest history of looking at maternity care in this way and you can see more here :https://en.wikipedia.org/wiki/Confidential_Enquiry_into_Maternal_Deaths_in_the_UK
And here: https://midwifediaries.com/mbrrace-new-cemace-time-part-one/
Hope this helps! xx