Friday, 16 February 2018

What is our North Star?

For those of you who have worked in the NHS for some years, you will recall it is just over 5 years since the publication of the Francis Report. Published in 2013, this report was the
culmination of a public inquiry into serious failings at Mid Staffordshire NHS Foundation Trust.

The damning report detailed first and foremost the appalling suffering of many patients. This was primarily caused by a serious failure on the part of the provider Trust Board, which didn’t listen sufficiently to its patients and staff or take action to address quality failings.

Also in the news over the last few weeks has been the report of the Independent Review undertaken by Sir Bill Kirkup outlining widespread failings surrounding community health services at Liverpool NHS Community Health Care. The findings make depressing reading as they highlight once more the dreadful impact for people of a disproportionate focus on the prioritisation of cost improvement plans over quality and patient safety; and the stress and adverse consequences for staff who tried to raise their concerns.   

As a number of key publications have done in the national media, this latest story calls into question just what has changed over the last five years? I have been ruminating on how we here at Pennine Care can avoid some of the mistakes highlighted in the report, especially given our challenging financial position. Of course, we all need to ensure we do everything we can to reduce waste and stop doing things that don’t add value. But how we do ensure that we do this in a way that doesn’t unintentionally impact on quality?

With this in mind, I think there are three key areas we need to focus on to mitigate this risk:

1) First and foremost we need to be clear on what guides us – what is our North Star? We should always place the development of high quality, compassionate and continually improving care and support at the heart of everything we do

2) Secondly, we need to ensure that any proposals to change services or reduce costs are always properly assessed for their impact. And not just with regard to each scheme but collectively. I keep saying that it’s like losing weight – a pound seems like a small amount, but if you keep losing a pound every week, pretty soon you are going to be in serious trouble! So, we must assess risk properly and produce Quality Impact Assessments to ensure any savings proposed are done so with a robust consideration of the impact on quality and safety

3) Finally, building on the Francis Report, we need to create a culture where people feel able to tell someone if quality is being compromised. You are our eyes and ears of this organisation and if you see things you’re not happy about, you should not be afraid to speak up. And if you hear or see stories of people who have been penalised for doing so, this is not acceptable and I want to know about it and understand why to ensure it doesn’t happen again. Our Freedom to Speak up Guardian (Lisa) is always on hand to listen if you don’t feel able to raise concerns with your managers.

I want to end this blog on a high and to say how pleased I am that our ‘Fluperheroes’ have worked so hard to ensure we are in the top 5 most improved Trusts in the Country for vaccination rates – well done! We are just a handful of people short of our 60% target, so if you haven’t had your vaccine yet, please see the intranet for details of how to get this done.

I’m always keen to hear your thoughts, so do email with any feedback.

Claire Molloy

Chief Executive


  1. It's nice to end a tough week reading such an open and honest account that focuses our efforts firmly on quality and truly values the staff voice. Thank you.

  2. A really enjoyable blog to read. Thank you.

  3. It shows the importance of reviewing the risks identified with any CIPs.