So you want to be a nurse?

T he UK Government’s initial response to the Francis Report, given in the House of Commons on 26 March by Mr Jeremy Hunt, Member of Parliament for South West Surrey and Secretary of State for Health in England, was brief. He did, I am very pleased to say, acknowledge that what went wrong at the Mid Staffs Trust was ‘Not typical and that the vast majority of doctors and nurses give excellent care day-in day-out’. Mr Hunt also noted that more time was needed to consider the report in full but that some response was required as a matter of urgency. A number of key areas for urgent action were identified and of course nursing loomed large among them. It is hard to disagree with much of the initial response, which focused on the need for compassionate care, zero harm, training for healthcare support workers, reducing frontline bureaucracy and a review of the complaints process. At last the Nursing and Midwifery Council (NMC) (and other professional regulators) were asked by Government to ‘tighten’ their procedures for dealing with cases of failure to adhere to professional standards. Some of you might share my view that ‘tightening’ does not come close to what needs to happen at the NMC and radical change to protect nurses as well as the public is long overdue. Sir Robert Francis said that the responsibility for what went wrong at Mid Staffs lies with the trust board. In response Mr Hunt says the Government will look at new legal sanctions at a corporate level for organisations that deliberately withhold information they are required to provide. It would have been helpful if he had assured us that board members would be required to have an understanding of the NHS before their appointment and some insight into what delivering safe compassionate care to millions of patients every day across primary community and secondary care actually means. It would also have been helpful to restate the need, as Sir Robert does (Recommendation 204) to have a nurse on the board of every healthcare organisation. Recommendation 187 from the Francis Report seems to have struck a particular chord with the Secretary of State and it appears already to be policy in the making. Recommendation 187 states