‘I'm beyond caring’, a response to the Francis Report: the failure of social systems in health care to adequately support nurses and nursing in the clinical care of their patients

Abstract

Lord Francis was commissioned to look at why the serious problems (between January 2005 and March 2009) at Mid Staffs Foundation Trust were not identified sooner and the appropriate action taken. Lord Francis was also asked to outline what lessons could be learned to enhance patient care. The report was delivered on 5 February 2013 and contained 290 recommendations. The key message was that the National Health Service needed to put the patient first and everything else should flow from that principle. Poor standards of care should not be tolerated and staff would be expected to speak out when they felt patient care was being compromised. Lord Francis also recommended that there should be one regulatory body and that the role of the Care Quality Commission was to be reviewed.

Keywords::

• nursing
• Francis
• defensive system
• contained
• management
• supervision
• paranoid schizoid
• container

Acknowledgements

I would like to say that all my views are my own and do not necessarily represent the views of the Tavistock and Portman NHS Trust. I would also like to thank the following people for their help in writing this paper. Ann Thornley (Staff Nurse Intensive Therapy Unit); Lis Jones (Director of Nursing Tavistock and Portman NHS Trust, Chair of the London Mental Health Nurse Director Group); Susan Hickman-Evans (Senior Clinical Lecturer in Nursing, Senior Fellow of the Higher Education Academy); Louise Fruen (Manager, Specialist Adult and Adolescent Mental Health Services); Dr David Somekh (Psychoanalyst and Network Director, European Health Futures Forum); Dr David Bell (Psychoanalyst, ex President of British Psychoanalytic Society and Consultant Psychiatrist at Tavistock and Portman NHS Trust); Mrs Edna O'Shaunessy (Distinguished Fellow, and training and supervising analyst of the British Psychoanalytic Society); William Halton (independent organisational consultant and executive coach) and Michael Rustin (Professor of Sociology University of East London).