DH Francis response hands GPs duty to monitor care quality

GPs should continuously review the hospital care their patients receive, the DH's long-awaited response to the Francis inquiry has said.

Jeremy Hunt: DH response to Francis report published

The DH response published on 19 November said that all GPs should report concerns about other services, keep themselves updated on the performance of services their patients use, and offer patients advice on these services.

It said: ‘GPs, both in their roles as care providers and in CCGs, should be continuously reviewing the quality of care provided by the acute hospital and specialised commissioning for standards services they commission.’

Health secretary Jeremy Hunt accepted 281 of the 290 recommendations made by the Francis inquiry report, published in February this year in the wake of hundreds of avoidable deaths at Mid Staffordshire NHS Foundation Trust.

The government confirmed plans for a statutory duty of candour for healthcare providers as part of CQC registration but ruled out one for individual doctors. GP practices will have to ensure that staff are open with patients and their families when there are failings in care and to provide an explanation for it, 'and where appropiate an apology'.

BMA chairman Dr Mark Porter said: ‘We are pleased that the government has heeded the BMA’s warnings over the introduction of a statutory duty of candour for individuals, instead strengthening the professional duty that already exists. It is vital that organisations actively listen to their staff and take on their concerns.'

Mr Hunt also announced plans for a new criminal offence for wilful neglect and for patients to be assigned a named nurse for each hospital shift to co-ordinate their care.

The DH response ruled making it a criminal offence for individual health professionals to mislead patients, commissioners or regulators about care patients have received, but argued that strengthening the CQC registration process and references to candour in advice from the GMC and other regulators would compensate.

The GMC has been tasked with producing 'clear guidance that professionals who seek to obstruct others in raising concerns or being candid would be in breach of their professional responsibilities’.

GMC chief executive Niall Dickson said: ‘Through our guidance, we have already done a great deal to encourage a duty of candour among doctors, but we are not complacent. We know there is more to do. We must strengthen the link between our guidance and doctors’ practice on the frontline, the words on the page and actions on the ward. We look forward to working with doctors and others to make that happen.’

Dr Porter said: ‘While extending wilful neglect as a criminal offence may go some way towards reassuring the public, it is unlikely to bring around the change in culture we need, and how this will work in practice is something that we will continue to discuss with the government as there are already criminal sanctions in place in order to hold healthcare workers, including doctors, to account.

‘Doctors play a vital leadership role across the NHS in driving forward change and we hope that doctors will be given a real voice in helping to meet the challenges the NHS faces in becoming an organisation that truly listens to both its patients and staff.’

RCGP chairwoman Dr Maureen Baker said that GPs’ high workload is threatening their patient advocate role.

‘GPs have an important role to play in ensuring that their patients' concerns about standards of care are dealt with swiftly and effectively,' she said. 'However, the capacity of GPs to take time to listen to their patients and act as advocates on their behalf is being compromised by the increasing pressure that general practice is under, with burgeoning workloads and steadily diminishing resources.

'It's time for the government to reverse this by increasing funding for general practice, allowing us to provide consistently high standards of care and act as a driver of quality throughout the NHS.’

From next April, all hospitals will be required to publish staffing levels on a ward-by-ward basis together with the percentage of shifts meeting safe staffing guidelines.

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