NHS safety review could challenge reform policy

The conclusions of the Mid Staffordshire Foundation Trust public enquiry may conflict with NHS reform policy, according to NHS Chief Executive Sir David Nicholson.

Speaking at the Patient Safety Congress 2012, Nicholson said there was a “very real” likelihood that the Francis report would recommend tighter regulation of FTs to protect safety.

Nicholson himself recommended to the enquiry that FTs failing to maintain safety should be taken back under NHS control, in direct contradiction to Government policy for FTs.

The enquiry into the Mid Staffordshire care scandal, in which hundreds of patients are believed to have died unnecessarily, has provoked urgent questions about the regulation of acute care.

In his initial report, enquiry chair Robert Francis QC said: “the evidence shows that the Board’s focus on financial savings was a factor leading it to reconfigure its wards in an essentially experimental and untested scheme, whilst continuing to ignore the concerns of staff.”

The final Francis report, including recommendations for FT regulation, was expected in May but will now be published in October (subject to DH approval).

At the end of the enquiry, Francis said he would consider such recommendations as increasing the regulation of NHS managers and merging the Care Quality Commission with Monitor.

These recommendations would conflict with the current direction of NHS reform, whereby central regulation is stripped back and Monitor’s role is shifted to economic regulation.

Nicholson told the enquiry that the DH should have the power to strip FTs of their independence – but that also, the way to prevent a recurrence of breakdowns in patient care did not lie only in regulation.

The main solution lay in better data collection and communication between NHS organisations, health workers, patients and the public, he said.