SCIE opinion - 27 March 2013

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Photograph of Andrea Sutcliffe

The Francis Report – what I did in 1983 is just as important today

From SCIE’s Chief Executive, Andrea Sutcliffe

As I expected, the implications of the Francis Report and the Government’s response published on 26 March 2013, will have far-reaching implications for the care and support system, not just the NHS. We are to have a Chief Inspector of Social Care, a new ratings system, fundamental standards of care whatever the setting, a barring system for healthcare assistants and so much more. First and foremost, and most welcome, is the focus on treating people with respect and dignity and ensuring compassion is central to the care we provide.

Initially the most eye-catching proposal – not least because it was leaked ahead of the official response – was for student nurses to first serve up to a year as a healthcare assistant. The published proposal reveals that this will be a pilot, carefully tested and implemented to ensure it is cost-neutral, and extending the scheme to other trainees will be explored.

This got me thinking about my first experience of the health and care system. As a teenager I volunteered at my local Gateway Club helping people with a learning disability take part in social and leisure activities, and then, in the summer of 1983, I worked as a cleaner in the NHS.

I have also talked to SCIE colleagues and they all have stories of their early days; one started washing up in a hospital kitchen before she eventually went into nursing; one was a nursing auxiliary; and I even found another hospital cleaner.

Reflecting on our experiences we all agreed that we learnt so much – some of it the hard way – and that these lessons, particularly about treating people with dignity and respect, have never left us as our careers have progressed.

For me, it was the impact a kind word, or a smile at the right time, could have for someone at their most vulnerable. I remember one woman saying that I was the only person who had been nice to her all day – I hadn’t done much, but it had meant a lot to her. I am not saying that lack of understanding and dignity is endemic; far from it. We hear of great examples from Dignity Champions every day.

What I am saying is that this is about culture – encouraging and enhancing a culture where a human response is natural, recognised and valued. This applies in hospitals, but also in people’s own homes or residential care.

My cleaning supervisor used to take me to one side and tell me not to talk to patients, even though I had finished my duties in double-quick time; she said it was not “my job”. I took no notice – I just made sure I looked busy when she turned up. That supervisor was wrong then and would be wrong now. It is all of our jobs, from the directors on the Board to the care assistant helping someone to eat; and everyone else in between. We all need to make sure that we are treating people using our services with dignity and respect – it needs to be the very heart of our person-centred culture.

So, while there may be different views about the best and most practical way to embed this culture, let us not be distracted, but concentrate on Robert Francis’s call to action to make the people we serve “the first and foremost consideration of the system and everyone who works in it”.

See also