After Francis: Research to strengthen organisational capacity to deliver compassionate care in the NHS.

After Francis: Research to strengthen organisational capacity to deliver compassionate care in the NHS

Date: 19 February 2018

Five years on from the Francis Inquiry, five NIHR-funded studies looking at the delivery of compassionate care in the NHS are publishing their results.

The NIHR, through its HS&DR Programme, put out a number of funding opportunities to help address the issues raised in the public inquiry which was launched following a higher than expected number of deaths at the Mid-Staffordshire NHS Foundation Trust.

The public inquiry, led by Sir Robert Francis QC, and published in February 2013, identified failings at the Trust. Two reports were produced, the first focused on the neglect of patients and poor standards of care, and the second considered the adequacy of regulatory and supervisory systems. It also highlighted issues of negative culture, tolerance of poor standards and disengagement from managerial and leadership responsibilities.

The NIHR’s HS&DR Programme - which provides robust research on the quality, access and organisation of health and social care services - called for research which would respond to particular areas highlighted in the reports where local organisations are asked to take action to strengthen patient voice, improve frontline care and change culture through leadership.

One study conducted the first UK evaluation of Schwartz Center Rounds - monthly forums that offer a safe space for healthcare staff to share experiences with colleagues and some of the challenges they face in their work. It found that that healthcare staff who regularly share the emotional, social or ethical challenges they face in the workplace experience less psychological distress, improved teamwork and increased empathy and compassion for patients and colleagues. Regular attendance has been shown to cut rates of stress in the workplace by at least half- from 25 per cent to 12 per cent. To read more visit the NIHR journals library website. Professor Jill Maben explains more about her reasons for getting involved in the study in her NIHR blog and has launched a guide and short film for organisations implementing Schwartz Rounds.

Another study found that frontline staff were keen to participate in compassionate nursing care interventions such as Creating Learning Environments for Compassionate Care (CLECC). They were able to implement many of the planned activities and valued the benefits to their wellbeing and to patient care. Nonetheless, organisational factors outside of the direct influence of the ward teams mediated the impact and sustainability of the intervention. The team concluded that mobilising the support of resources such as senior manager input, and targeting wider organisational culture for change, are likely to result in improved impact and sustainability. View the project page for more details.

A third study aimed to establish whether ward teams in acute NHS Trusts had the information systems they needed to manage their own work, and report on that work to Trust boards and other stakeholders.

Three of the four acute Trusts studied implemented real-time ward management systems, that gave nurses and other staff greater operational control over the quality and safety of care.
The team found that, in 2013, Trust boards received minimal routine data on the quality and safety of services.  By 2016, though, the situation had been transformed, with comprehensive data being reported and discussed every month.

View the First Look Summary.

Two ongoing NIHR studies funded in response to this inquiry include:

Professor Jo Rycroft Malone, Director of the HS&DR Programme said: “Some of the problems experienced at Mid-Staffordshire were extreme. However, all NHS organisations can learn from the findings of this investigation. Five years on from the Francis Inquiry, NIHR research is providing valuable insights helping those working in the NHS to address issues of how to improve standards, provide space and opportunity for learning, and create the conditions for manager and leader engagement. Looking to the future we are dedicated to funding studies which will continue to put care and compassion of staff as well as patients at the heart of the NHS.”

For further details on the projects referenced above visit the NIHR journals library website.


References
Bridges, J. May, C.R., Griffiths, P. Fuller, A. Wigley,W. Gould, L. Barker, H. & Libberton, P. (2017) Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care. BMJ Quality & Safety.

  • Summary:
    Five years on from the Francis Inquiry, five NIHR-funded studies looking at the delivery of compassionate care in the NHS are publishing their results.
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