Review by Steve Fouch - CMF Head of Allied Professions Ministries

The horror stories that emerged from the five enquiries into the failure of care at Mid Staffordshire NHS Trust have shaken the national belief in our health service. Patients left in soiled bedclothes, people being triaged by A&E receptionists, appalling hygiene standards, patients left on gurneys in severe distress... The litany of abuse and neglect goes on. Hundreds of patients (maybe over a thousand) are thought to have died unnecessarily as a result, and many more have suffered needlessly.

What is more, those who raised concerns were ignored, threatened or silenced, and the regulatory mechanisms that should have picked up on these failings simply did not work. There was something rotten in the state of the NHS as whole, not just in Mid-Staffs.

The publication of the second Francis Report (1) has sought to address this wider, systemic failure. It has spared no one's blushes in its criticisms of institutional blindness and self-interest trumping the needs of patients across professional and regulatory bodies and the Department of Health.

Francis makes 290 recommendations. Central to them is that transparency becomes a legal duty for NHS trusts and professional bodies, and that there needs to be an overall culture change in the NHS, that puts patients and their needs at the centre of the system. This seems so fundamental that the inquiry's need to state it explicitly suggests how far the NHS has drifted away from its original purpose.

Significantly, while good leadership is vital to this, Francis makes it clear that the culture change is the responsibility of every NHS employee, from 'porters and cleaners to the Secretary of State'. It is a bottom up change, not further top down restructuring that is needed.

A change in culture only arises from a shared set of values and beliefs. This presents a challenge and opportunity for us as Christians to express the God-given value of each and every person made in his image, (2) the centrality of compassion as an expression of God's love and character, (3) and of service and advocacy for those in need as central to an expression of his justice. (4)

Many are calling this a 'watershed moment' for the NHS. It may well be a 'kairos' moment, when 'eternity erupts, transforming the world into a new state of being'. So let us not just hope that the Francis Report is a spur to action in others, but also a spur for us as Christians to be agents of change and transformation in the NHS.