The Francis Report into the scandal of Stafford Hospital needs to be read thoroughly by all senior managers for the lessons to be learned about executive responsibility. 

The inquiry chaired by Robert Francis QC was set up to assess the wider lessons to be learnt by the NHS from the Staffordshire scandal where up to 1,200 patients died unnecessarily because of widespread failings in both Mid-Staffordshire Trust and the wider NHS.

In a letter to the Health Secretary Jeremy Hunt he says the story is one of "appalling suffering" which was "primarily caused by a serious failure on the part of the (hospital) board.  It did not listen sufficiently to its patients and staff. It failed to tackle an insidious negative culture involving a tolerance of poor standards."

The report is particularly critical of the strategic health authority with responsibility for Stafford Hospital – which was run by the now head of the NHS Commissioning Board Sir David Nicholson.

The report’s findings should be seen by the HR professional communty as a wake-up call to show genuine leadership mettle, according to Dean Royles, director of the NHS Employers organisation.

"As a result of the Inquiry all NHS organisations will be taking a hard look at their core HR approaches and working on Organisational Development plans that will collectively affect the lives of the 1.3 million NHS employees and the millions of people who use our services each week," says Royles. 

"NHS HR leaders will be responding by driving a major cultural change within their organisations to ensure staff are engaged and passionate about care. We simply cannot rest on our laurels and hope that outside agencies such as regulators can make the change for us."

He adds: "This is going to be a major test of our HR community. But if we get it right we can turn what is undoubtedly a tragedy into an opportunity for exceptional staff engagement, driving improvement in patient safety, patient experience and patient outcomes that would be a fitting tribute to those who suffered at Mid Staffordshire."

A major challenge

Royles warns that the task ahead is a major one. "This will probably be the greatest Organisational Development challenge we will ever face," he suggests. "It will call for exceptional and innovative approaches to staff engagement as we try and pick staff up from the de-motivation and distress caused by ongoing revelations about poor care within parts of the NHS.

"We will have to use all our knowledge and expertise to develop plans that involve recruitment and selection, performance management, training and development, induction and reward, as well as approaches to management development and leadership. Most importantly, we have to continue to build staff confidence to be able to raise concerns knowing they will be supported to do so."

Similar points were made by Petra Wilton, Director of Strategy and External Affairs at the Chartered Management Institute, which recently reported that only one in five managers are professionally qualified for their roles. 

 “The Francis Inquiry Report has today exposed the depth of the catastrophic management failings at the Mid Staffordshire NHS Trust. It is clear that poor management standards and senior management failings led to hundreds of unnecessary patient deaths," says Wilton.

"It has highlighted that bad management, when it comes to the NHS, really can cost lives. Urgent action is needed to ensure those working in management positions across the health service have the skills and training needed to bring about the necessary improvements in patient care."

Wilton adds: “It’s clear from the report that there was a dangerous separation between the senior management teams and those providing frontline care, which created a blame culture within the hospital with staff feeling under-valued, unsupported and in fear of reprisals if issues were brought to light.

“There is a huge need to encourage staff to be more open and there has to be a sense of accountability at all levels to stop such inexcusable mistakes being made again. Whilst more regular and wider monitoring is welcomed by many, it is also essential that managers have the training and support needed to meet the standards expected.  

"Independent inspections can play a key role in raising standards, but it is critical that the need to meet targets does not continue to cloud core objectives such as staff wellbeing and patient care," she concludes. 

 “It is vital that the report recognises the importance of building skills and performance against professional management standards and ensures that all staff, whether clinicians or managers, are encouraged to get qualified and recognised for their management skills.