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Opening up the culture

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The ‘Mid-Staffordshire Inquiry’ (Francis Inquiry) relates to the Mid-Stafford Hospital which has approximately 350 beds and is run by the Mid Staffordshire NHS Foundation Trust. The Inquiry (chaired by Robert Francis QC) was established to examine the cause of failings at the hospital between 2006 and 2009. The Inquiry published its report in February 2013. More recently the UK Government published its official response to the 290 recommendations contained in the report. In adopting in principle all bar 9 of the recommendations, the UK Government acknowledged the fundamental need to establish an open culture in the NHS. In light of the much publicised calls for a ‘Duty of Candour’ in this jurisdiction, the UK Government’s approach to this issue is undoubtedly being monitored closely.

The Eversheds LLP team of 30 led by Peter Watkin Jones acted as solicitors to the Francis Inquiry. They provided advice and gathered and analysed all evidence from inception to conclusion. The UK Government has now adopted all bar 9 of the recommendations. A brief summary of the key steps to be taken by the UK Government on foot of the recommendations are set out below.

(a) Obligations of candour and openness

The UK Government has accepted the need for a Duty of Candour to apply to care providers.

Following an interim payment to a family in respect of a recent birth injury case in Ireland, the family and its lawyers called for a similar Duty of Candour (and an obligation on professionals to report mistakes) to be introduced in this jurisdiction.

(b) Fundamental standards

The recommendation to establish Fundamental Standards with ‘zero tolerance’ has been accepted. In the UK they will be regulated by the Care Quality Commission (CQC).

In this jurisdiction practitioners must be compliant with the National Standards for Safer and Better Healthcare, with a key focus on the ‘patient first’ approach. HIQA is the equivalent inspection and compliance body in this jurisdiction.

(c) Staffing and nursing

By summer 2014 the National Institute for Health and Care Excellence (“NICE”) will provide independent evidence for the NHS of what ‘safe staffing levels’ look like.

Needless to say this will no doubt be of significant interest in this jurisdiction also. While there is no direct equivalent of NICE in this jurisdiction, healthcare practitioners ensure compliance with the guidelines of relevant regulators such as the Irish Medical Council, the Irish Nursing Board and CORU.

(d) Professional discipline

Greater obligations will now be placed on professionals in terms of candour, openness and reporting of ‘near misses’ for errors.

The question of who will have responsibility for compliance and enforcement in relation to the proposed duty of candour in this jurisdiction has, we understand, not yet been determined.

(e) Leadership

A ‘fit and proper person’ test will apply to all board level appointments, policed by the CQC.

Proposals in this regard are no doubt being watched very closely and cautiously in this jurisdiction.


Eversheds Peter Watkin Jones states that the UK Government’s response is welcome and that the recommendations will contribute to a ‘patient first’ approach in the NHS, grounded on openness and transparency. Head of Healthcare, Aisling Gannon believes that the learnings from the Inquiry are probably equally applicable and potentially as relevant in this jurisdiction.

If you are interested in engaging with/contacting Head of Healthcare, Aisling Gannon of Eversheds Dublin or Head of Inquiries, Peter Watkin Jones of Eversheds Cardiff, please contact in the first instance.


This information is for guidance purposes only and should not be regarded as a substitute for taking legal advice. Please refer to the full terms and conditions on our website.

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