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Executive Summary

1.0 The Society and the College of Radiographers’ response to the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (the Francis Report),1 chaired by Robert Francis QC is set out in this publication. It is the culmination of several months of work by the Society and College of Radiographers to identify lessons for the radiography profession and workforce and for our organisation. We felt it was important to reflect carefully on the learning and the recommendations arising from the public inquiry as members of the radiography workforce could, at any time, come into contact with patients experiencing unacceptable standards of care. 

2.0 The Inquiry Report contained a large number of recommendations which, in the main, we support. However, there are two with which we disagree to some extent. These are dealt with in sections 8.1 – 8.3 and 14.11 – 14.13 of our full response but are summarised here for completeness.  

3.0 We do not agree with the finding that the Health and Safety Executive (HSE) is not the right organisation to be focusing on healthcare (recommendation 87) although we agree that it should work closely with the Care Quality Commission. 

4.0 We are unconvinced that a system of registration, particularly a statutory register, for healthcare support workers is necessary (recommendation 209) although we agree with the need for the framework within which healthcare support workers operate to be clarified and strengthened. Our own approach for the assistant workforce in radiography is to set out the scope of practice and associated standards of education and training, with individuals seeking and maintaining accreditation and entry to our public voluntary register; increasingly NHS employers are requiring this of their employees. We also insist that assistants work under the supervision of a registered healthcare professional and that they adhere to our Code of Professional Conduct.2

5.0 There are other recommendations which we feel have been too narrowly framed and which should apply to the spectrum of healthcare professions as well as to doctors and nurses . For example, it is important that the work of the National Institute for Health and Care Excellence (NICE) is informed by the allied health professions (radiography being one of the allied health professions) and NICE can and must do more to incorporate the expertise of these professions in its work. Similarly, the allied health professions should be represented at board level and board membership should be open to them as well as to doctors and nurses. Boards are vital structures with ultimate responsibility for ensuring safe and effective care of patients; they need competent and capable allied health professions just as much as they need doctors and nurses and we expect boards along with the UK health departments, NHS England and NHS employers to fully support staff to take up board level positions and to contribute to the work of NICE.

6.0 We also question whether recommendations made in relation to the General Medical Council and to professional regulation of fitness to practise should be extended to our own regulator, the Health and Care Professions Council where appropriate.  

7.0 Importantly, we wanted to ensure that our work and the leadership, guidance and support we provide for the profession takes account of the findings of the inquiry in tangible and lasting ways. At the end of our detailed considerations, we believe we have a much stronger Code of Professional Conduct2 that sets out for the profession and workforce clear expectations about the values and behaviours expected of them. It embeds the need for our profession and workforce to be honest, truthful and open with patients at all times and, while we have some concerns about legislating for openness, transparency and candour, the radiography profession and workforce should be in no doubt about what is expected of them in this regard.    

8.0 In addition, we have developed and will continue to grow a range of support, guidance and other tools that will help the profession and workforce to ensure that patients are properly at the centre of their work at all times.  

9.0 The table at the end of this executive summary sets out specific actions we have either taken or will be taking in the coming months.

10.0 Finally, the Inquiry Report has given us the opportunity to reflect at length on our historic structures and functions as both a professional and a representative body. We have concluded that these enable us to support our profession and members in delivering excellent, safe and compassionate patient care (see section 14.10 and Appendix 2 of our full response).  As both a professional and a representative organisation, we wholeheartedly support Robert Francis QC’s call for impact and risk assessments to be made public and to be publically debated prior to the acceptance of major structural change to our healthcare system. This would be consistent with the need for openness, transparency and candour which, together with the need for excellent leadership, is at the heart of the Inquiry Report.   

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