Mid-Staffordshire NHS Scandal Analysis

Critically analyse how clinical governance can ensure accountability of individuals and teams and that nursing practice is safe and of a high standard?

Over the last 15 years or so a number of cases concerning patient care and safety have come to light prompting investigations and inquiries that have led to changes in the way care is delivered. These include inquiries at Winterbourne View hospital, Mid-Staffordshire hospital(Mid staffs) and Harold shipman to name a few.

In May 2011 the BBC released undercover footage about the appalling way vulnerable residents at Winterbourne View Hospital were being treated, once the footage was released it came into light that the owners

Stafford Hospitals unimaginable failing were published after having one of the most heart breaking news in the history of the NHS. Below I have briefly summarised and researched the time line of Stafford Hospital.

After the serious shortcomings within the Mid-Staffordshire NHS Trust came to light, The Francis Report (Francis, 2013) investigated how the conditions of inexcusable care could prevail within the trust. The Francis Report proposed several extensive changes that could improve the National Health Service (NHS). Garner (2014) informs that these changes include that leaders need to be effective and accountable, staff should be empowered to work in partnership, each trust should aim to improve innovation and quality, whilst putting the patient first. The Department of Health (DH) reflected on the findings and in response to The Francis

In line with the majority of other developed countries, the United Kingdom (UK) has offered its citizens a universal health care system that is free at the point of service. Funded primarily by taxation, the system is popular and efficient. However, along with most other health care systems around the world, it faces a series of challenges if it is to maintain viability, in the twenty-first century. These issues include; long waiting times, an aging population, funding challenges and the increasing cost of technology.

The Health and Social Care Act 2012 came into force with crucial principles including new structures and arrangements in health care services to safeguard and strengthen the future of NHS and maintain the modernisation plan. In this Act, many new changes has been made to a number of existing Acts, National Health Services Act (NHS 2006), in order to enable health care system to tackle the existing challenges and also avoid any potential crisis in future. It has also introduced the proper allocation of NHS fund and budget, and improved the integrated care between NHS and social care services to promote patients’ choice in terms of delivering quality care.

Later, findings from a series of reports including report from Royal commission on National Health Insurance in 1926; The Sankey Commission on Voluntary Hospitals in 1937; and reports from British Medical Association (BMA) in 1930 and 1938, all collectively indicated that inadequacy existed in the pattern of the services (Christopher, 2004; Webster, 2002). Evident were reports of conflicting care and duplication of work between the municipal and voluntary hospitals (Wheeler & Grice, 2000). Additionally, world war had a huge impact on the health services and the conditions in which hospitals, theatres, radiology and pathology department operated was very poor. Thus, no machinery existed that supported running of a coordinated healthcare system, hence a need for unified, simplified and cohesive system was felt (Smith, 2007). Furthermore, Royal Commission’s report suggested that funding for the health services might benefit from general taxation rather than its basis on insurance principle (Christopher, 2004). However, it was not until the Beveridge report in 1942, which provided a huge drive and momentum for a movement of change in the health services. And within subsequent years seen were the proposals for NHS drawn through the White Paper in 1944, then in 1946 the National Health Service Act and at last in 1948 the establishment of the NHS

The NHS and Community Care Act 1990 states that wherever possible services should be provided in the community or in the home as a large amount of money was being spent on residential and care homes for the elderly. The Local authorities must carry out an assessment of needs and must arrange for the care or provision. Also the local authorities were encouraged to purchase care from a mixed economy, including statutory, private and voluntary sectors to encourage competition and increase choice. (Classroom notes, 2014) / (Patient, 2015)

He claimed that a new shift system had caused at least one death and one unnecessary operation taking place, and said that he and a small number of consultants were overworked and patient safety and continuity of care were compromised. The claimant had told the Manchester hearing he raised his concerns about the new ‘Consultant of the Day’ system with the trust clinical director Mr Watson and then the trust medical director Mrs Schram; however, he was reprimanded and told not to voice concerns again. The consultant said he was then investigated over a series of ‘malicious, vexatious and frivolous’ allegations and ‘imaginary deaths and complications had been conjured up’ to create a case against him. He believed that the investigation and the process from the beginning was about punishment for raising his clinical concerns, and he argued that the investigation did not examining the veracity’ of the allegations against

Today I am going to be talking about how immigration from the European Union affects the NHS- our national health service.

In 1974 reform of the NHS seen eliminated the involvement of local authorities in health, set up community health councils, introduced area health authorities and changed the management of family doctor services (JISC 2015). The conservative Government reforms of the NHS bought much controversy, supporters claimed the reforms brought increased efficiency and effectiveness, but opponents said they undermined the founding principles of the health service (BBC 1999). However the spending cost of the NHS was a concern, with an ageing population and increase of new advance technology, experts said that the NHS needed above inflation increases of at least 1% a year simply to stand still (BBC 1999). The government, inspired by the Griffiths Report (1983), blamed disorganised management and structures within the NHS for the cash problems (BBC 1999). The National Health Service and Community Act of 1990 was the future explanation (BBC

Key reforms Power to commission services will be devolved to GPs working in consortia. National and regional specialised services will be the responsibility of the new NHS Commissioning Board, not GP consortia. GP consortia will have a duty to work in partnership with local authorities, for example in relation to linking up health and social care. The new NHS Commissioning Board will take over current CQC responsibility for assessing NHS commissioners and will hold GP consortia to account. Role of CQC will be strengthened as the quality inspectorate for health and social care. Monitor will become the economic regulator for health and social care from April 2012.

The National Health System began in 1948 with the aim to provide free health care for the English thus removing health access inequities. This essay considers two strengths of the NHS, being free health and locally responsive health care and two weaknesses being the financial burden and unprecedented pressure on health care resources.

The NHS Operating Framework introduced by the coalition government sets out the planning and financial requirements for RUHB in 2012/13 and the basis of their accountability (DH, 2012). As a result, the 2013 certified that funding for health in England be frozen for up 2015/16 thereby requiring RUBH to underspend allocated funding from the government such as putting a 1% cap on pay award. Socially, this will include factors such as behavior of staff and service users, partnership working, quality of care, etc. These factors can drive change in diverse ways in the RUHB. For example, the NICE Guidelines on Behavior Change make recommendations on individual level behavior interventions that is aimed at changing the behavior that can be dangerous to the health of staff and service users such as smoking, alcohol abuse, lack of physical activity, safe sex, etc. (NICE, 2014). Technologically, the introduction of information communication technology has resulted in faster communication, appropriate storing and sharing of information and records of service users between health and social care professionals. As a result of the CQC inspection, the RUHB revises their health records management policy to more accurately reflect where information about service user such as fluid intake and output in each ward should be recorded (CQC Report, 2013)