Reflections on Francis - One Year On


One year on from Francis, the Chief Executive of Gloucestershire Hospitals NHS Foundation Trust, Dr Frank Harsent, reflects: 

“It’s important to recognise that while the Francis report into the care provided at Mid Staffs Hospital was a watershed moment for the NHS, locally we have been and continue to deliver high quality care for the majority of our patients the majority of the time.

“To list off a number of initiatives that have taken place at the hospital since the report was published and to badge them ‘Francis’ wouldn’t recognise the more complex programme of work that we are involved in here to provide high quality patient care.

“What Francis has done for us locally has been to present an opportunity to enact change and to actively demonstrate to patients that we will provide the best levels of compassionate care.

“Our response to the report and subsequent government findings has been a considered one as we look to the areas identified where we can make continued progress and can enact further long-term, sustainable change.

“We held a series of engagement meetings with our staff following the publication of the report last year to see what they thought was important to our Trust. Following this, our Board identified four key areas:

  • Leadership & Training: consistent with a patient-centred culture
  •  Recruitment: values-based, compassionate care
  • Transparency and openness: accessibility of data, and lessons learned
  • Culture: safety, behaviours, carers and patient involvement, raising concerns


“Compassionate care as an explicit core value has been incorporated into all our clinical development programmes. The commitment to the development of our staff and particularly the continuing education of our nurses and healthcare assistants is something we can justly be proud of.

“For the last 10 years we have benchmarked the number of nurses in our hospitals and their skills mix against the ever changing needs of patient care. As a result there has been considerable investment in nursing over the last year alone. Again while Francis endorses the nurse staffing benchmark tool that we use, we haven’t done this as a result of the Francis report. So, for example, just last Friday at our main Board we announced a further investment of around £900,000 in 17 new nursing posts and 11 new healthcare assistant posts to boost the nursing numbers for some of our most vulnerable patients in our elderly care wards.

“As part of a wider review of care, the Trust has also appointed Supervisory Ward Sisters to every ward. We agreed that our senior nurses require dedicated time to lead, supervise and monitor their team’s performance and to fulfil their role as the key patient contact for their ward.

“Reinforcing our commitment to prioritising patients, we appointed a new Head of Patient Experience last May. Under her guidance, we continue to develop new initiatives aimed at improving and addressing the needs of our patients and their carers. We launch our new Carers’ Badges next month, which is the latest in a series of improvements to carers’ benefits. We are also looking to improve the way we respond to complaints and comments about our services.

“Safety continues to be a key priority for our Trust. Not only are our safety priorities communicated to our staff via a number of channels, we have also increased the ease with which staff can report any concerns they have. This can be done in a number of ways without fear of consequences, and this is the message that we are consistently reinforcing – that our staff can speak out and raise their concerns, safely.

“With reference to transparency, we are currently devising a way of showing our performance data - which is publicly available - in a more accessible, user-friendly format, so that patients can see at a glance what other people are saying about us and the quality of our services.

“While there is more to do, I am absolutely clear that the quality of care provided to patients, their safety and their experience in our hospitals is of the utmost importance to us and to our dedicated and valued staff.”


Dr Frank Harsent


Gloucestershire Hospitals NHS Foundation Trust