Impact of Francis Inquiry one year on

Publication date

Tuesday, February 11, 2014

Approval date

Tuesday, February 11, 2014

Financial pressures and a complex regulatory environment are making it difficult for hospitals to create the kind of patient-centred culture recommended by the 2013 Francis Report, according to new research.

Health think tank the Nuffield Trust published its findings on the first anniversary of the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry to examine how hospitals have responded to the findings and recommendations contained in the report by Robert Francis QC.

Drawing on in-depth interviews with around 50 staff at five acute hospital trusts and an online survey of chairs and chief executives at more than a third (53) of acute and foundation trusts in England, the new report found hospital leaders describing how meeting financial goals and ensuring safe staffing levels in hospitals was very difficult and will only get harder in the future.

However, the senior NHS staff interviewed for the research also said that the Francis Report had added impetus to their efforts to put quality of care as their top priority.

As one chairperson said: "The one good thing Francis has done, the really good thing, is that it has ensured that safety and quality have become more prominent – that’s really important."

The Nuffield report, which is available at, also found that some hospital boards were finding it hard to meet increased demands for assurance and scrutiny from external regulators and commissioners that have arisen since Francis.

Leaders often described a burdensome regulatory approach that seemed to be at odds with, and could distract from, their efforts to develop an open quality-focused culture in their own organisations.

One leader told the Nuffield Trust: "I’ve never, in my whole career, felt more regulated."