Robert Francis QC will publish his report tomorrow on the public inquiry into the commissioning, supervisory and regulatory bodies responsible for the failed Mid-Staffordshire NHS Foundation Trust.

This will be the fifth review of the systemic failures in the trust between 2005 and 2008.

Commencing with the Healthcare Commission’s report and ending with the upcoming second Francis report in February, the findings amount to the what will be widely regarded as the worst failing of care provided by the NHS.

Francis’s first report, published in 2010, looked at the care provided by the trust, and was  commissioned by then health secretary, Andy Burnham.

It found that patients suffered considerably during the period under investigation, suffering degrading continence care, poor personal hygiene and worrying safety issues such as falls leading to serious injuries.

There was also severe neglect in the provision of nutrition and hydration, as well as a failure to provide meals and water to patients, or to support patients to eat the meals with drinks placed out of their reach.

Evidence of low standards of cleanliness and hygiene and infection control was also uncovered.

One of the key recommendations from the inquiry was that there should be an investigation into the regulatory bodies supervising Mid-Staffs during the period, as none had picked up on the difficulties.

The latest report into the Trust, out tomorrow (6th February), is a full public inquiry – as ordered by Andrew Lansley in 2010 – into the reasons why the oversight bodies saw nothing wrong.

The current chief executive of the NHS, Sir David Nicholson, who was chief executive of the Strategic Health Authority responsible for the trust, has faced calls for his resignation, but feels he has a role to play in implementing the recommendations of the latest inquiry.

Patients at the trust have continued to suffer poor treatment, and only recently the case of the baby found with a dummy taped to its face made headlines.

Mid-Staffs chief executive’s January 2013 report to the trust board shows that Monitor, the healthcare regulator, has declared the Trust both clinically and financially unsustainable, meaning it is likely to be subject to the Unsustainable Provider Regime.

This could mean it is subject to a ‘failure regime’ and broken up and taken over by other trusts.

The political context, cuts, staff morale, and the role played by the media are all likely to be part of the picture when the report of the public inquiry is published, and the recommendations are expected to have wide ranging and radical implications for NHS reforms.

We will have more on the report into the Mid-Staffordshire Trust later on Left Foot Forward.

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