Cast Study Critique Report on "Francis Report 2013 (Recommendation 15)" About Mortality Statistics

Term Paper, 2016

23 Pages














The report explored the Francis report regarding Mid Staffordshire NHS Foundation. The report also examined and analysed the recommendation 15 of Francis report based on Mid Staffordshire NHS Foundation. The report mainly highlighted the mortality statistics of the Mid Staffordshire NHS Foundation and how mortality statistics influenced the entire hospital as well as NHS foundation trust through the different performance strategies. Mortality statistics was done through data collection, data analysis, assessing hospital performance, and publishing the final audit report, while the report highlighted that auditing was the best strategy to improve the total performance of the hospital.

In addition, the critique report recommended seven principles for medical auditing for instances clinical and health providers individual’s duty, self-management of the medical staffs, availabilities of the auditing, essential criteria of the auditing, required resources of the medical auditing, record keeping, and evaluation of the final audit outcomes by various medical and non-medical experts. These seven principles were identified as effective and significant to provide the quality care of the patients and improve the overall performances of the medical organisations.


The report will explore the Francis report regarding Mid Staffordshire NHS Foundation. The report will also examine and analysis the recommendation 15 of Francis report based on Mid Staffordshire NHS Foundation. The report will particularly highlight the mortality statistics of the Mid Staffordshire NHS Foundation and how mortality statistics can influence the whole organisational structure and help to improve the hospital performance (attached is appendix 1). In addition, the critique report will recommend some of the significant strategies to improve the quality of the services of Mid Staffordshire NHS Foundation.

The Mid Staffordshire NHS Foundation Trust was a NHS foundation trust and managed two hospitals named Stafford and Cannock Chase Hospital in Staffordshire, England. However, Stafford Hospital was quite bigger (350 inpatient beds) and Cannock Chase Hospital was a bit smaller (115 inpatient beds). In 2008, the trust was awarded as a NHS foundation trust, while in 1993 it was named Mid Staffordshire General Hospitals NHS Trust and around 3,000 employees worked in the two hospitals (Healthcare Commission, 2009). Unfortunately, there was a scandal reported in Francis report. The report published that there were about 400 to 1200 deaths at the Mid Staffordshire NHS Foundation Trust due to poor quality care, lack of facilities and failures of medical treatment between 2005 and 2009. Therefore, Government had taken that case as serious issues and organised an independent investigation. Francis was appointed for this investigation and completed by 2011. After investigation, he published his full 2000 pages report in 2013 and divided into three volumes. He also provided almost 290 recommendations (Francis, 2013).

Francis outlined 290 recommendations in his full report. Recommendation 15 is about Mortality statistics. The analytical report will analyse recommendation 15 and identify as how Mortality statistics can support and influence to improve the quality of the hospital performance through regular data collection, data analysis, assessing hospital performance including medical and non-medical staffs, publishing final outcomes in various media and journals (attached in appendix 1). The Mid Staffordshire NHS Foundation Trust was in dreadful condition in term of quality performance and they failed to serve the quality of care to the patients. Publication of the Mortality statistics in the public report would play significant role to improve the hospital performance (Lindenauer et al., 2007). In addition, assessing staff performance and record the death rate in the hospital would be crucial to influence their high performance along with high quality of patients care (Marshall et al., 2000).


This section will explore the recommendation 15 of Francis report and critically analysis the effectiveness of the mortality statistics to improve the hospital performance. Mortality statistics could be done through various protocols for instances data collection, data analysis, assessing hospital performance, and finally publishing outcomes in the mass media or journals (shown in figure 1). As a policy maker, under the department of health, could imagine the following effective strategies what could be implemented in the national health industry (NHS) particularly the Mid Staffordshire NHS Foundation Trust. The following analysis would be supportive to improve the quality of the hospital performance through the addressing all the existing problems in the light of Francis recommendation 15. The key analytical descriptive criteria are described below:

Abbildung in dieser Leseprobe nicht enthalten

Figure 1: Mortality Statistics Protocol (Francis, 2013)


Data collection is very crucial to investigate or inquiry or do research on any kind of health or business industry. Lindenauer et al., (2007) stated that data collection is the best way to justify the subject areas or assessing the performance of any staff or hospital or industry. For example: Francis investigated on the Mid Staffordshire NHS Foundation Trust and finally outlined his report, while he initiated his first steps through data collection before assessing the hospital performance.

Data could be collect through numerous ways for instance survey or feedback. Survey could be done through the distribution of questionnaires or interviews like face to face, telephone, or Skype interview (shown in figure 2). Survey could be done monthly or annually.

Abbildung in dieser Leseprobe nicht enthalten

Figure 2: Data collection process (Lindenauer et al., 2007).

In addition, data could be collected through feedback from patients during discharge from the wards, relatives or hospital visitors in online survey. After getting survey result, hospital authority could know the deaths rate, drawbacks, and performance of their quality of the care. Based on their quality ratings, hospital authority would take initiative to improve their performance in term of quality of care. Therefore, mortality statistics through data collection might influence the hospital overall performance.


Data analysis is very significant for the health research. After data collection, data should be analysed to get desirable outcomes or main findings (Shiloach et al., 2010). Once data collection is done, then data would be ready for analysis to get full idea about the consequences of the hospital critical issue or development of the hospital performance. Data analysis could be done through mainly three ways for instances specialist data analyst, data assessment, and data interpretation (Shiloach et al., 2010). After data collection from the hospital, data could be analysis through various agents. Suitable and meaning full data analysis makes research outcomes realistic and feasible.

Abbildung in dieser Leseprobe nicht enthalten

Figure 3: Data Analysis Process (Shiloach et al., 2010).

Death rate could be analysed based emergency department performance, conditions of the patients, treatment facility, and quality of care. In addition, hospital overall performance including Doctors, Nurses, HCAs, Dieticians, physiotherapist, pharmacist individuals performance might be assessed through data analysis (shown in figure 3). Researchers, data analyst, policy maker would be involved to analyse the data through numerous suitable statistical tools like SPSS, PASW or SAS (Binu, Mayya and Dhar, 2014). This analysis would provide total overview as how is hospital performing. If death rate is high then need to take initiatives against weakness or where lack of motivation or performance is involvement.


Assessing hospital performance is the vital part to improve the quality of the hospital. There are numerous body could be involved with this assessment to make valid outcome to avoid any types of biasness. Internal and external body could take part actively to appraise the performance in the hospital. For instances CQC (Care Quality Commission), internal hospital audit, department of health (DOH), Local Government, Local Volunteer Organisations (shown in figure 4) (Peterson et al., 2006).

CQC could inspect the hospital from top to bottom for instances quality of care, staff skills and performance, food and nutrition of the patients, hospital hygiene, infection control, fire safety measures, pest control, update record of the medical devise, staff validation documents, training up to date, patients feedback, death rate in each ward, conditions of the of the patients (Shaw and Costain, 1989). Based on all those conditions as well as mortality statistics, CQC could make their suitable score and that score would be valid until next year and if any weakness then that would be done within the provided timeframe. CQC ratings would be helpful to know about the hospital performance.

Abbildung in dieser Leseprobe nicht enthalten

Figure 4: Hospital Performance Assessment Protocol (Peterson et al., 2006)

Internal audit is also another assessment body but it is actually under internal assessment. This is very significant for the hospital authority to know their own performance before publishing in the public place and before that they could resolve their problem without publishing. It could be ward based as well as based on whole hospital. In the ward based assessment, nurse in charge could be mentors and lead the team to assess the individual ward performance for instance hourly rounding, food and fluid chart, checking the patient weight, their treatment plan and overall the patient satisfaction score during discharging from the ward. Nurse in charge or ward manager could perform this audit on the day to day basis (Shaw and Costain, 1989).

Similarly, internal auditing based on mortality statistics and patients’ safety is very crucial to assess the overall performance and quality of the organisation. Effective and frequent auditing of patient safety and management body ought to be appraised to achieve better position in the health industry. Based on case study, there was huge debate was involved in management section and significant evidence of the ignorance of their duty and responsibilities to conduct the regular auditing in the hospital and appraise the staff performance. Francis (2013) reported that Non-executive member of the hospital of Mid Staffordshire NHS foundation trust even did not visit the hospital as well as ward in person and he used to reply on third person in term of reporting and inquiry.

In addition, the management body had no especial health background apart from Sir Stephen Moss. The aim of the early auditing of the death rate and patient safety could support to identify the current problems and also helped to improve the services. It was noted that frequent auditing much effective rather than annual auditing. Hanskamp, Sebregts et al. (2013) purported that frequent audit of mortality ratio and patients safety is supportive to appraise the hospital performance for instance more death rate denotes that poor quality or care or treatment failures. These points could influence the policy to put in place on time to turn forward the hospital performance.

Likewise, all other ward could perform same ways to assess the rest of the wards in the hospital. In addition, mentors or senior in charge of the hospital could monitor the all medical and non-medical staff from Doctors, Nurse, HCAs, Pharmacist, and Physiotherapist performance. They could appraise the staff skills and performance. Hospital could organise internal training to retrain the staff to enhance staff skills before involving any kind of accident. This is way internal audit could be done in the hospital. Shaw and Costain (1989) stated that internal audit is the best audit to improve the hospital performance as it helps to appraise the staff and whole hospital performance and there is more likely to get better performance after internal audit without any kind of penalties.

Department of health (DOH) could be involved directly with the inspection of the hospital as well as all NHS foundation trust. DOH could also monitor patient safety and put the patient first in the health services. Quality of the care would be improved if Mid Staffordshire NHS Foundation Trust follow the ideal principle and put patient first in their service then quality and performance could be developed easily (Department of Health, 2013).

Local Government could also be involved to inspect the quality and monitor the performance of the local hospital. Staffordshire local Government would initiate to visit the hospital and make formal inspection in every three months a year. Local Government audit report might be supportive to improve the performance through the addressing the findings involved with negative consequences. In addition, local volunteer organisation like Health Watch, Live Well would also inspect the local hospital to assess their performance, what could be helpful to validate the final audit and there would a chance of biasness (Lindenauer et al., 2007).


Publication is the most significant part of the health research to explore the update about the subjects. Research or any kind of investigation is meaningless without publication in the public site. During the scandal of Mid Staffordshire NHS Foundation Trust, publication was the only responsible to publicise the news. For example: Francis investigated the case but without publication no one knew about the scandal.

Therefore, publication is most significant and crucial for the research. Auditing data publication is essential to increase or develop of any hospital or medical institute or medical services (Millar, Freeman and Mannion, 2015).


Excerpt out of 23 pages


Cast Study Critique Report on "Francis Report 2013 (Recommendation 15)" About Mortality Statistics
University of Bedfordshire  (MBA (Health Services Management))
Organising Modern Health Care Services
Catalog Number
ISBN (eBook)
ISBN (Book)
File size
1132 KB
This text was written by a non-native English speaker. Please excuse any errors or inconsistencies.
cast, study, critique, report, francis, recommendation, about, mortality, statistics
Quote paper
Mr Kamalesh Dey (Author), 2016, Cast Study Critique Report on "Francis Report 2013 (Recommendation 15)" About Mortality Statistics, Munich, GRIN Verlag,


  • No comments yet.
Read the ebook
Title: Cast Study Critique Report on "Francis Report 2013 (Recommendation 15)" About Mortality Statistics

Upload papers

Your term paper / thesis:

- Publication as eBook and book
- High royalties for the sales
- Completely free - with ISBN
- It only takes five minutes
- Every paper finds readers

Publish now - it's free