06 February 2013

The Royal College of Physicians welcomes the Inquiry’s call to make patients the priority at all times. The Inquiry identified key problems that make it difficult for doctors and nurses to provide good quality care, such as a lack of team working and lack of continuity of care.

The RCP believes that parts of the system must change to better meet patients’ needs. The Inquiry’s findings echo RCP members and fellows’ experiences as highlighted in our own Hospitals on the edge? report published in September 2012*. This is why we established the groundbreaking Future Hospital Commission in February 2012, which is reviewing the standards and processes for care of patients in hospital. It will report in June 2013.

Sir Richard Thompson, president of the RCP, said,

‘Patient safety and quality improvement is a shared responsibility between healthcare professionals, managers and others working across the system. The RCP is committed to continuing our leadership role in ensuring doctors take responsibility for holistic care, not just diagnosis and treatment, and all care must be compassionate. Many of the Inquiry’s findings match those in Hospitals on the Edge? and we will incorporate the Inquiry’s recommendations into our Future Hospital Commission.'

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

‘All patients must receive high quality care that meets all of their needs. Robert Francis QC is right to put this at the heart of the NHS. To facilitate this, both the system and patient care pathways must be designed around patients’ needs and ideally co-designed with patients. To meet changing patients’ demands, hospital services must change. Currently, services have to fit around outdated systems that no longer meet the needs of today’s patients. Clinically led, evidence based service redesigns that embed patients’ needs must become a reality.’

Dr Patrick Cadigan, registrar of the RCP, said,

‘The RCP welcomes a more unified approach to regulation with greater rigour and clinical and lay involvement. We agree that education and training should only take place where good quality care is provided. One of our recommendations to the Inquiry was that quality should be embedded in the commissioning process with greater clinical input and we are pleased this is included in the final report. We look forward to working with NICE to develop more and better quality standards. We welcome the recommendation of aspirational standards, which royal colleges are well placed to develop.

‘Robert Francis QC should be congratulated for making recommendations that will directly affect patient care within hospitals. We welcome the emphasis on frontline healthcare professionals in ensuring the delivery of high quality care and strongly support the view that a named senior clinician should take responsibility for each patient. Care of older people should be improved in hospitals and team work is crucial to this.’


* The RCP also highlighted systemic problems in the NHS in its September 2012 report Hospitals on the edge? These include:

  • increasing pressures on acute and emergency services
  • patients with increasingly complex health and care needs
  • lack of continuity of care, with patients often moved several times during their stay
  • breakdown of patient care out-of-hours
  • a looming crisis in the medical workforce.

Hospitals on the edge? and the RCP/RCN guidance on ward rounds are both mentioned in the Inquiry, on pages 1392 and 1394 respectively. The RCP has been a core participant to the Francis Inquiry. 

The RCP represents 28,000 hospital doctors 

The RCP has recently developed the following quality improvement guidance:

National Early Warning Score

Ward rounds in medicine: principles for best practice

Acute care toolkits


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