1. The Francis Report and its impact for care providers Professor Ian Peate © e-GNCS Limited 2013. All rights reserved. No part of this publication may be reproduced or distributed without prior written consent from e-GNCS Limited.

2. At the end of the presentation you will be able to: Consider the key issues and apply them to your own setting Reflect upon challenges and opportunities Discuss the education and training needs of HCSWs (Health Care Social Workers) Aim and Objectives The aim of the presentation is to: Outline issues in the Francis report and relate them to the care sector

3. http://www.youtube.com/watch?v=0B0hEPU3Kt4 Any changes to hospital regulation following the Francis report on the Mid Staffordshire public inquiry must include care homes (The Relatives and Residents Association)

5. Is a lawyer Was Francis the right person? Robert Francis QC This is the second enquiry Unnecessary deaths All about the NHS (Mid Staffs) Applicable across all sectors Ignore this at your peril 290 recommendations

6. Recommends sweeping changes for regulation Recommends the registration and regulation of health care support workers Robert Francis QC Proposes a statutory duty of candour, staff will be obliged to speak out Calls for legislation Calls for criminal convictions

7. Leadership (or lack thereof) The trust, their focus on targets and savings Criticisms The NMC The CQC Monitor The RCN

8. Regulation The right numbers of staff with the right skills Safe staffing and a regulated Staffing levels included in the CQC’s future monitoring of care settings Finance/quality balance CQC and Monitor to work closer together Regulation is not the panacea for all ills that befall care home

9. Leadership From the bedside to the board room Fit for purpose Demonstrate deep understanding of the connection between patient outcomes and staff engagement Culture Staff to speak up when they see examples of poor care (whistle blowing) Listen to patients and staff Progression planning

10. Government response (late March) Vast majority of the people who provide care are decent, hard working individuals committed to provided the best possible standard of care Next steps Vast majority of people who deliver care give good, quality care despite the severe pressures that they are placed under due to a lack of resources

11. Pay greater attention to staffing levels if poor care is to be eliminated Make clear the impact that systematic failings can have on the delivery of patient care Next steps Does not require massive organisation change, a renewed emphasis on what is truly important - common values, intolerance of non-compliance, commitment to openness and candour at all times Five more hospitals under investigation

12. National code of conduct for HCSWs Strengthening identification of HCSWs Health Care Support Workers Seven recommendations out of the 290 specifically relating to HCSWs. Four key areas: Registration of HCSWs Set of common national standards for the education and training of HCSWs ? ? ? ?

13. Uniform description of HCAs (title) Strengthening identification of HCSWs Role clarity, and communication of this Set of common national standards for the education and training of HCSWs

14. No unregistered person should be permitted to provide care ‘for reward’ in a care home setting, unless they are members of their own family or have a genuine social relationship Registration of HCSWs Voluntary register has little or no advantage for the public Mandatory vs Voluntary registration Regulator should be the same as that for RNs (NMC)

15. Code of conduct aligned to standards of education and training National Code of Conduct Wales has one Scotland has one In England Skills for Health and Skills for Care are working on one

16. Consistency in education and training Common national standard for education and training of HCSWs Will help to ensure patient safety, the whole workforce can feel confident in HCSW abilities Provides access to further education and training as needed for their role Career progression In England Skills for Health and Skills for Care are working on minimum standards

17. Scotland Code of practise for employers of HCSW Plays a major part in public assurance around the employment of HCSWs Builds on the fundamental principles of patient safety and public protection Supported by existing systems of clinical governance and staff governance

18. Undervaluing of the nursing task and those who perform it Failings in nursing care (Francis) Poor recruitment Deficiencies in initial and continuing training Poor leadership Inadequate staffing Declining professionalism

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