hospbedRoyal College of Midwives chief executive Cathy Warwick has said the findings of the report into care failings at Mid-Staffordshire NHS Trust make the introduction of minimum safe staffing levels and a duty of candour a necessity.

The report, released yesterday [6 Feb] by Robert Francis QC found that "appalling neglect and abuse" at Stafford Hospital had led to hundreds of unnecesary deaths between 2005 and 2008.

The long-awaited Francis Report produced 290 recommendations aimed at "fundamental change" to prevent the public losing confidence in the health service. These included:
- Units that failed to adhere to basic standards of care should be prevented from providing services
- NHS staff should also face prosecution if they hid information about poor care
- Senior managers to be given a code of conduct and the ability to disqualify them if they are not fit to hold such positions
- An increased focus on compassion in the recruitment, training and education of nurses, including an aptitude test for new recruits and regular checks of competence as is being rolled out for doctors

Commenting on the findings, the RCM chief executive said: "The recommendation to introduce a new duty of candour is an excellent suggestion. We hear far too often from midwives who are genuinely petrified about raising the alarm bell over poor quality of care. They fear that senior managers will come down on them hard simply for raising concerns.

"We need to transform the culture of the NHS so that midwives and others who need to raise concerns feel happy and secure in doing so. NHS staff must never again be afraid to raise concerns about standards of NHS care. Today must be a watershed for the NHS.

"We welcome that NICE will be asked to set minimum safe staffing levels for the NHS. For too long the NHS in England has been thousands of midwives short, and we are at the edge of safe care. Minimum safe staffing levels for maternity care will mean that finally the NHS will be forced to recruit the midwives and other NHS staff needed to provide safe care. The safety of people being cared for by the NHS must be paramount and regulating all those providing care helps achieve that."

Following the report, Prime Minister David Cameron has announced that five further hospitals with persistently high death rates over the past two years(Colchester University, Tameside, Blackpool Teaching, Basildon & Thurrock and East Lancashire) will now also be investigated.

Queen's Nursing Institute chief executive Crystal Oldman has also welcommed the findings, saying they highlight the importance of a patient-centred care approach.

"The QNI’s Right Nurse, Right Skills campaign has, since 2011, highlighted the loss of skills within community nursing teams and the problems that this brings," she added. "It is time that the NHS acknowledged that a shortage of qualified nursing staff (in hospital or community) leads to poorer health outcomes for patients, especially for those who are most vulnerable and dependent.

"If the NHS is to keep the public’s trust it has to invest in a properly skilled and well-led nursing workforce, supported by regulated healthcare assistants, trained to deliver the care that we want for our loved ones and ourselves."