Reservations expressed about government response to Francis

Published: 26 March 2013

The Royal College of Nursing has today responded to Health Secretary Jeremy Hunt’s statement outlining the Government’s initial response to the Francis inquiry.

Dr Peter Carter, Chief Executive & General Secretary of the Royal College of Nursing, said: “The Francis inquiry was comprehensive and based its recommendations on several years’ worth of evidence. We agree with the Government that the quality of care is as important as the quality of treatment. There was a great deal to welcome in Robert Francis’  broad range of recommendations and we would now urge the Government to build on the actions they have set out today and work with us to go even further. Together we need to ensure that we do everything possible to prevent another situation like Mid-Staffordshire.”

The RCN welcomed the commitment to look at staffing levels, an issue the College has been raising for several years. “However the reality is that nurses continue to work with up to 11 patients each in older people’s settings, and with even higher numbers in care homes,” Dr Carter stressed. “Simply leaving the setting of staffing levels to local discretion clearly isn’t working and the time has come for mandatory, legally enforceable safe staffing levels. It’s what patients need, deserve and increasingly will start to demand.”

The Francis inquiry was also clear about the need for a register of all health care support workers (HCSWs) and the RCN is disappointed that the Government has missed an opportunity to enshrine this in law. The RCN believes that voluntary regulation may provide false reassurance and that a system based on referral to the Vetting and Barring Scheme could help keep a HCSW with a suspect record hidden, moving from one employer to another.

“We have a number of urgent questions about the suggestion that all student nurses should first spend a year working as an HCSW,” added Dr Carter.

“Who will train, employ and monitor tens of thousands of these support workers? How can the Government deliver this radical change to nurse training on a cost-neutral basis? And how will we ensure that the supply of nurses does not become restricted?

"We are committed to working closely with government and key partners on clarifying these concerns and ensuring that the pilots are fully evaluated and the results are acted upon. However, let’s be clear, last year’s independent Willis Commission found no evidence that nursing education is failing, nor that it is associated with a decline in compassion."