There is little doubt that every wise healthcare leader will consider what lessons the Francis report has for their organisation, and it is their response that matters most

“Everyone ‘knows’ who should resign and precisely why,” says Professor Aidan Halligan of the response to the Francis report. But the former deputy chief medical officer has little time for such pious certainties.

“Most of us,” he writes, “reflect what Francis writes in his report − wilful blindness, the bystander phenomenon and normalisation of deviance.” He claims: “The report provides the single greatest leadership challenge the NHS has ever faced.”

‘It is how NHS organisations react to the report that really matters − not the government response’

A dedicated man like Professor Halligan, the NHS’s first ever director of clinical governance, may be forgiven for slipping into hyperbole − but there is little doubt that every wise healthcare leader will consider what lessons the Francis report has for them and their organisation.

Inspiration and introspection

The inquiry chair’s first recommendation was a requirement for “all commissioning, service provision, regulatory and ancillary organisations in healthcare” to consider how to apply his recommendations to their work. Robert Francis no doubt chose that order because he wanted to stress that it is how individual NHS organisations react to his report that really matters − not the government response.

‘The NHS can learn lessons about improving patient safety from the armed forces’

Professor Halligan places his faith firmly in “a new cadre of clinical leaders”. Commissioning board non-executive director Ciarán Devane instead calls for “parity of esteem between the patient voice, the clinical voice and the manager”. The key is that each organisation and individual takes responsibility for improving care.

One final point is that the NHS must guard against too much introspection and instead look for inspiration wherever it can be found, however counter-intuitive it may feel.

A perfect illustration is that both Professor Halligan and Mr Devane explain the NHS can learn lessons about improving patient safety from the armed forces.

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