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RCP sets challenge to realise Francis' vision

The Royal College of Physicians (RCP) has committed to a series of wide-ranging actions to help realise the recommendations of the Mid-Staffordshire NHS Foundation Trust Public Inquiry, and has called on other healthcare organisations to rise to the challenge set by Robert Francis.

The RCP has set a challenge to individuals in the healthcare system such as consultants, doctors in training, other members of the healthcare team, NHS managers and politicians to ‘contribute to a culture change in the NHS by putting patient safety, patient experience and quality improvement at the heart of all they do.’

The actions are set out in the RCP’s detailed response to the Francis Inquiry, Putting patients first, and outline how the healthcare profession should act upon the recommendations made by Robert Francis QC.

Download the RCP's full response to the Francis Inquiry

Contained in the RCP’s full response are 33 actions for the RCP, including:

  • To develop an Elder-friendly Ward Quality Mark in partnership with the Royal College of Psychiatrists and others. The quality mark will be awarded to general hospital wards that provide high-quality care for older people.
  • To develop a ‘Hospital Health Check’ model of aggregating available data on trusts. This includes data about trust participation in national clinical audits and quality improvement programmes, RCP examination activity, consultant physician workforce demographics, clinical time, morale, and retirement plans.
  • To review RCP examinations to ensure that competencies about raising concerns and treating patients with dignity are included.
  • To work with other organisations to agree definitions for the three tiers of standards recommended by Francis; fundamental, quality and aspirational. These three tiers must be understood across the healthcare profession.
  • To engage all trainees in developing leadership skills and support doctors to develop management roles.
  • To work with the Care Quality Commission to develop a meaningful and effective system to inspect and rate hospital services.
  • To develop physician guidance on raising concerns, including embedding this in revalidation.

Pivotal to the RCP’s response to the Francis Inquiry is the ground-breaking Future Hospital Commission, which was established to review all aspects of the design and delivery of inpatient hospital care. The Commission will report on Thursday 12 September and has focused on redesigning the hospital system to facilitate high-quality, compassionate patient care. The Commission’s report will be a means to implement many of Francis’ recommendations, especially those relating to compassion and coordination of care.

The RCP has also set out a number of challenges for other organisations. These include the Department of Health and NHS England embedding professional bodies in policy development, the Care Quality Commission regulating hospitals and other care providers in a way that meets Francis’ recommendations, and the General Medical Council working with professional bodies to assist quality assurance of education and training.

The RCP has committed to review its response to the Francis Inquiry on an annual basis.

Download the RCP's full response to the Francis Inquiry

Commenting on the RCP's full response to the Francis Inquiry, Patrick Cadigan, RCP Registrar, said:

It is our role as a royal college to answer the 'it’s too difficult' question. The RCP‘s response to the Francis Inquiry sets us on the road to achieving this.

Many of the instances of substandard care at Mid-Staffordshire NHS Foundation Trust took place in medical wards caring for our most vulnerable patients: frail older people with complex comorbidities. Achieving “gold standard” care for this group must be the priority. It will make a substantial contribution to ensuring that the events at Mid Staffordshire are never repeated.

Francis’ vision of the patient at the centre of everything the NHS does forces us to reconsider our own actions as individuals and as a body of professionals, and leaves no room for complacency.

Suzie Hughes, chair of the RCP’s Patient and Carer Network, said:

In their response to Francis, the RCP has set a challenge to its members: they must contribute to a culture of openness by embedding and learning from patient experience. Medical leadership is key to improving patient experience; we must move to a system where doctors lead by example.

We must get care right for the most vulnerable group, who are often the most challenging to treat: frail older people. The challenge is to embed the experience of this group in hospital care – getting it right for them is our first benchmark.


For further information, please contact RCP public affairs manager, Andrew McCracken, on +44 (0)203 075 1354 / 07990 745 608 or email andrew.mccracken@rcplondon.ac.uk

Notes to editors