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Culture change in the NHS: Applying the lessons of the Francis Inquiries

1.This document sets out the progress that has been made in applying the lessons learned from the tragic and inexcusable failings at Mid Staffordshire NHS Foundation Trust. Much has changed. A new, rigorous inspection regime has been introduced for hospitals, GPs and adult social care – and three Chief Inspectors have been appointed. More than half of acute Trusts have already been inspected. In special measures Trusts, 1,805 extra nurses and nursing support staff have been hired, with 109 more doctors and 129 changes in board-level leadership. There are now over 21,300 more clinical staff working in the NHS than there were in 2010. Although levels of avoidable harm are still too high, more than 94 per cent of patients receive harm-free care. More than five million Friends and Family Test responses have been collected from A&E, inpatients and those using maternity services. And 77 per cent of people say they would feel safe in an NHS hospital if they were very ill – which, although not high enough, still compares favourably by international standards where the NHS was last year ranked as the safest healthcare system in the world.

2.While much has been achieved, the achievements and improvements made since the publication of Sir Robert Francis QC’s Public Inquiry report must be sustained and embedded for the future and applied equally and rigorously across all sectors of the health and care system. Each chapter of this document sets out the key areas where further action is needed to ensure that safe, effective and compassionate care is the norm. The online supporting annex to this document sets out in detail the substantial progress made against the 290 recommendations of the Public Inquiry.