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Government responds in full to the Francis Report

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Health secretary Jeremy Hunt presented the government's full response to Robert Francis QC's Report into the Mid-Staffordshire care failings, on 19 November. This followed the government's initial response in February of this year.

Mr Hunt has partly accepted all of the recommendations laid out in the Francis Report (57 in principle and 20 in part) with the exception of nine, three of which were about the regulation of healthcare assistants.

Included in the response was the announcement that the government will not introduce a minimum staffing level for nurses. Instead NICE will produce guidance to ensure NHS services implement safe and efficient staffing levels. The guidance will initially focus on adult wards in acute in-patient settings. From August 2014, safe staffing levels will be published for other NHS settings including, community nursing care teams, learning disability teams in the community and mental health community units. The NICE guidance will focus on nursing and midwifery staffing levels and will include nursing support staff.

Hunt said that more nurses are currently being recruited into Trusts and community teams. Initial plans indicate that Trusts intend to employ an increase of 3700 nurses in 2013/14. This was welcomed by Peter Carter, the general secretary of the RCN. 'However, what we need now is an immediate boost to nursing numbers as part of a longer-term approach to workforce planning, with increased nurse training places so that trusts are able to recruit more nurses when they need to, without having to rely on overseas workforces,' he said.

Elizabeth Robb, the chief executive of the Florence Nightingale Foundation, has also highlighted the importance of nursing staffing levels. 'There is enough evidence out there to show a direct link between numbers of registered nurses and the quality of care delivered to patients.'

Rachael Maskell, Unite's head of health, described Hunt's response as 'inadequate.' 'What Hunt outlined won't disguise the fact the public and staff can see there are not enough nurses. And our concerns are not just about the acute sector and A&E departments, but they also focus on inadequate staffing numbers in community nursing which puts families at risk,' she said.

The Francis Report also called for clearer pathways into nursing education to ensure that there would be a greater intake of student nurses to raise the number of nurses in the future.

Healthcare Assistants

The government has rejected Francis' recommendation that healthcare assistants be regulated. Instead there will be a new certificate for healthcare assistants to ensure that there is a basic level of training and skills for the entire workforce.

Pilots will also continue for some nurses seeking NHS funding for nursing degrees, in which they will be required to work as HCAs before committing to nurse training to ensure that they are properly suited to the profession.

The Care Quality Commission (CQC) has announced it will appoint three new chief inspectors for hospitals, adult social care and primary care, and has consulted on a new system of ratings and of fundamental standards.

To find out more information about all of the recommendations laid out in the Francis Report and the measures that the Department of Health will take to meet them visit:

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