What happened in Mid Staffordshire was not one person, nor was it one group of nurses or doctors or managers. It was a whole range of things – from a heavy focus on targets to not listening to patients, dismissing data and allowing a culture of fear and poor style of leadership to take hold – all of which meant nurses, doctors and managers lost sight of safety and quality.
In his report, Robert Francis recommends a series of actions which we wholly endorse. He talks of enforceable standards, openness, transparency and candour, improved support for care and nursing, strong patient centred healthcare leadership and accurate and useful information. Work is already underway in many of these areas.
He specifically says that ‘a leadership college should be created to provide common professional training in management and leadership’ and that it ‘should be a physical presence that will serve the role of reinforcing the required culture through shared experience and will provide a common induction into the expectations of the NHS of those who lead and work in the system.’
The NHS Leadership Academy is, I believe, the organisation Robert Francis envisions for the NHS.
He asks for the promotion and research of best leadership practice in healthcare, a leadership framework which puts an emphasis on patient safety, accreditation for leaders, common standards of competence and compliance and specifically, a more co-ordinated approach to nurse leadership.
We are already helping nurses, doctors and managers to become better leaders so that they develop and foster environments where compassion, safety and the quality of patient care is their number one thought. We’ve already helped around 3000 NHS staff to do this and will be helping thousands more in the coming years.
We are about to launch a series of nursing and midwifery leadership, as well as foundation, mid and senior level programmes – working with thousands of NHS staff to equip them with the knowledge, experience, skills and behaviours to be the best they can, to empower others and to question ways of working they don’t agree with. And we have already started to work with world leadership experts and NHS staff to revisit our leadership framework. It no longer properly reflects the culture and behaviours we all seek for our NHS and the time is right to change it.
There is no quick fix but what we do know is that there is a lot of evidence that tells us that leadership development is crucial to improving the safety and quality of patient care.
The full effects of our development programmes will take time – and indeed we’re only just at the beginning of our journey in helping all different levels and groups of staff in the NHS. But if we are to get this right, rather than looking for a quick win, then we absolutely need to invest long term.
What patients and their families tell us about their experience will be our ultimate measure of the success of our leadership programmes – and we will be listening to them all the way.