A repeat of Mid Staffs errors is ‘inevitable’, warns Sir Robert Francis

The QC who carried out a review of failures at the Mid Staffs Hospital five years ago says that a similar collapse is ‘inevitable’ under current circumstances where some health trusts are accepting impossible performance targets. 

In an interview with Shaun Lintern for the Health Service Journal, Robert Francis QC warned of a “a real danger of a relapse” unless the present NHS leadership continue to focus on the lessons learned in Staffordshire.

The QC described a repetition of the same problems as “inevitable” in cases where financial stress is combined with unrealistic targets. He said: “If you look at the number of trusts who are not only in deficit but won’t agree their control targets, the fact some are not agreeing their control targets is good because it means they are saying we can’t actually do that and carry on the service you want us to provide. But there will be those that have said ‘yes’ when they actually can’t do it. Absolutely yes, that is a danger.”

Asked about NHS Improvement, the new regulator, and its recognition of current pressures, Sir Robert was more positive. He said: “I would like to think there is more acceptance at NHS Improvement level than perhaps there has been in the past, and I think there is an approach and understanding of the importance of keeping the quality agenda going.”

Sir Robert Francis is a non-executive director at the Care Quality Commission. He chaired the Mid Staffordshire NHS Foundation Trust Public Inquiry which produced its 290 recommendations on accountability, standards of behaviour, putting patients first and other areas in February 2013. The Inquiry found “serious failure on the part of a provider Trust Board” resulting in the “appalling suffering of many patients”. 

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