Back in 2013, Sir Robert Francis QC published his “Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry” which examined the causes of the failings in care at that particular hospital between 2005 and 2009. The report made no fewer than 290 recommendations, including the need for:
• openness, transparency and candour throughout the health care system
• improved support for compassionate caring, committed care and stronger health care leadership.
Months later, the Coalition Government and the Department of Health would respond to the Francis Inquiry Report with “Hard Truths: The Journey to Putting Patient’s First”, resulting in David Cameron offering a public apology to the families and individuals who suffered “from the most appalling neglect and mistreatment…Many were given the wrong medication, treated roughly, or left to wet themselves and to lie in urine for days. And relatives were ignored or even reproached when pointing out the most basic things which could have saved their loves ones from horrific pain or even death.” The Prime Minister went onto reference a number of organisations from The Primary Care Trust, Monitor, General Practitioner’s, the Royal College of Nursing and the Department of Health itself for failing to act, going onto say “the way Robert Francis chronicles the evidence of systemic failure means we cannot say with confidence that failings of care are limited to one hospital”.
For me, this post is quite personal, having previously worked for the Government prior to the release of the report, I had the opportunity to meet with a great many number of people who had either personally been affected by poor treatment or known of a loved one to have suffered at the hands of either Mid-Staffs Hospital itself or at another NHS site. It also struck me, that despite many people coming with complaints they also cared immensely for the NHS as an institution, cared for the Doctors and Nurses dedicated to their profession working in trying circumstances and deeply wanting it to continue as a service but just one which was safe instead.
By the time the hospital’s failings were eventually exposed by regulators in 2009, it is believed up to 1,200 patients had died needlessly. Horror’s included one patient dieing of an untreated urine infection having originally gone to hospital with a broken arm and a urine infection, one patient spending nine months in hospital having contracted three superbugs having just given birth and another died following a bowel cancer operation, the operation was deemed a success, but their epidural was dislodged leaving the individual without pain relief for days.
Five years on, I now find myself reflecting on some of the findings and thinking about how technology, particularly Microsoft technology can and could be being adopted up and down the country. Hand in hand, we can help the NHS move out of the shadow which still looms large over it, help it not just strive but genuinely achieve its stated objective, which is an NHS safe for everyone.
Sir Robert Francis’ report found a culture often only interested in explaining the positives rather then critically analysing itself. Thanks to tools like Power BI and Dynamics, we can now genuinely help the NHS with culture and accountability. We can assist hospitals by recording patient confidence and sentiment towards it via Social Media, thus enabling a hospital to promote good examples of care where it may have arisen, but importantly it can also engage with disgruntled individuals who may have been unhappy with there level of care and address those concerns both in private but if necessarily, publicly as well. It can enable an organisation to quickly, with fewer heads make accessible data and reports readily available much more regularly to the public. If they can showcase their patient waiting times, success rate of treatments etc. they can potentially generate more demand for their services due to patients being able to make better informed observations about one site over another which could positively impact funding streams for one over another.
Often during the evidence hearings, individuals interviewed spoke of “hindsight” and “if only they had seen the warnings”. The Trust was an organisation that lacked insight and awareness of the reality of the care being provided to its patients according to Robert Francis QC. Thanks again to Power BI, today there is simply no excuse for any hospital to still be working from static spreadsheets. Crucial mortality data which can be a key indicator of trends in poor care, can be spotted, examined and picked up in highly visual features, with time slicers to review trends by weeks, days, hours or even minutes by hospital, department or individual doctor or nurse. This offers tremendous and invaluable insight which could help shine a light on both poor care or extraordinarily good care, which would prevent anyone in future manifestly failing to act on readily available data.
Back in 2013, public satisfaction was at a low ebb with the NHS. Due to tight budgets and aging populations, pressure continues to mount for the NHS, which will inevitably generate more headlines in 2018, thanks to its 70th anniversary fast approaching. Five years on from the Inquiry, based on the question: “How satisfied or dissatisfied would you say you are with the way in which the NHS runs nowadays?” polling, records a six-percentage-point drop in satisfaction, to 57%, and a seven-percentage-point increase in those saying they are dissatisfied, to 29%, its worst approval rating in a decade, with many blaming a shortage in staff. The NHS can learn from the commercial industry who are putting Microsoft tech to good effect to use data to enable them to forecast peak times when more staff will be required, such as retailers making sure they have enough shop assistants during the Christmas shopping season for example. This could be used to help with ensuring safe staffing levels during winter which we know is historically challenging for the NHS or it could be used to assist our tourist hot spots which might require more workers on a temporary basis during peak holiday seasons for example but might not want the long-term cost of employing heads on a permanent basis.
And finally, collaboration between agencies, there was universal recognition amongst all parties that they were not joined up enough in the last decade. Whilst legislation no doubt plays its part, our NHS and all associated organisations linked to it can help itself by adopting the latest technologies and using more productive tools like Skype for Business which could allow doctors to treat patients remotely and enable a patient to make their recovery at home without needing to go out into the elements. Windows 10 and Azure allows for safe and secure storage of patient data, which will help the NHS meet today’s cyber-security challenges and threats from both home and abroad. Other things which spring to mind include DocuSign would allow Doctors and Nurses to sign off medications electronically thus saving on paperwork, whilst Surface Hubs and VAR can be used for training purposes, teaching individuals from far and wide, thus helping to lower costs without compromising standards.
Technology will not put right the wrongs of Mid Staffs or any other organisation which has failed its patient, but it can help the Government, the NHS and others learn from the lessons and make positive and significant steps forward in the right direction. The findings of the Francis Inquiry were truly shocking and whilst some progress has no doubt been made, many will acknowledge that not enough progress has been made.
Five years on the technology has got better, now it is time for them to put digital and technology at the heart of it’s strategy and take bolder leadership if it is to continue for a further 70 years and beyond.
Please note a Podcast was recorded on the 28th March 2018; to listen to this and other risual Podcast’s please visit – https://soundcloud.com/risual