Agenda item

To update the Health and Wellbeing Board regarding the Francis Inquiry and the Government’s response to the Inquiry with the purpose that the Board discusses and agrees a mechanism to identify the partners’ roles and responsibilities to implement the recommendations.

The Board received an update on the Francis Inquiry and the Government’s response to the Inquiry. The Board were asked to consider and agree a mechanism to identify partner roles and responsibilities to implement the recommendations.

The Chairman welcomed Sarah Bellars, Nurse Governor for the Clinical Commissioning Group, lead for safeguarding. Sarah Bellars made the following points:

• The report was huge and the third of its kind, it included 290 recommendations. The Department of Health had only just formally responded to the report in the previous week. Up until that point it had been difficult for health organisations to respond.
• Sarah Bellars would be chairing a steering group to oversee this work and would be inviting a representative from Local Healthwatch to participate in this work. A joint action plan would be developed, which would cover the whole local health economy. The steering group would need to report to NHS England by the end of the year. It was hoped that a joint action plan could be developed by July/September. It was envisaged that each individual organisation would undertake a review; reviews would then be gathered together to develop a joint action plan. The Board noted that a number of actions were already in place.
• The steering group’s initial focus would be around commissioners but by July, this would be much wider and would encompass providers and numerous other interested parties.
• Where there were glaring gaps in service areas, these would be addressed immediately. A large mapping exercise would be necessary to understand what already existed and what needed to be put into place.
• The Board noted that it wasn’t just one section of the NHS that needed significant improvement, a system wide approach was required, which would require all stakeholders to come together. It was clear that commissioners would need to lead this work.
• The role of the Board in this work was unclear however once the mapping exercise was complete, this would become clearer.

The NHS England representative reported that in advance of the Francis Report, quality surveillance groups were being established across England. These groups were meeting monthly and brought together commissioners and this included local authority representatives. These groups didn’t include providers and provided an opportunity for concerns to be raised in a semi formal way. She stated that a local authority representative would be welcome to join the group. Local Healthwatch would also be welcome to join this group.

The Chairman stated that the Francis report highlighted that some elected members did not know their role and in particular the expectation that they should be challenging health partners. It was important that elected members were aware of groups locally and at least be given the opportunity to ask questions, as they would be held to account by local residents.

The Board noted that it was important to understand the role of the Board as opposed to Overview and Scrutiny. The Board would take plans forward, whereas Overview and Scrutiny would undertake a scrutiny role.

The Board made the following points:

• An overriding element of Francis was that patients were not listened to; a strong voice was needed to provide intelligence on this.
• Board members would need to ensure that when questions
• were raised, that these are followed up.
• The Board noted the importance of whistleblowing and staff working in a culture where they felt at ease to raise concerns.
• The Department of Health would be introducing a staff survey which would provide a reflection of the culture of health organisations.
• A Friends and Family survey would also be introduced, for patients to complete within 48 hours of discharge. There was some scepticism as to how effective this could be, it was acknowledged that it wasn’t a perfect tool. Sarah Bellars agreed to provide a brief on this for the Board.

The Chairman of the Overview and Scrutiny Health Panel was invited to speak and stated that he endorsed all that had been said. He believed that Overview and Scrutiny could play a role by asking questions and scrutinising data and information produced by health organisations.

The Public Health Consultant stated that Public Health could assist in the collection of open ended qualitative data to assist Overview and Scrutiny.

It was RESOLVED that the Board;

i)                    agreed to take responsibility for oversight of the implementation of the recommendations.

ii)                   proposed a workshop to clarify roles and responsibilities for all organisations with a responsibility for implementing the recommendations.