17), these failures caused patients to suffer partial loss of vision or complete blindness, they also reported that patients died as a result of poor care. The report identified persistent evidence of care that fell below standard and the trust was placed in special measures. Without intervention from the CQC the findings would have been more catastrophic. The Nursing and Midwifery Council (NMC) (2017) and the CQC now work in partnership to promote patient safety and improve service, a driving force for the NHS, similarly NHS England and NHS Improvement recently came together as a single organisation, likewise to better support the NHS and improve patient care (NHS, 2019).

Similarly, an independent inquiry chaired by Robert Francis QC found many failures in the quality of care at Mid Staffordshire NHS Foundation Trust resulting in a complete breakdown in fundamental nursing care and in the wider governance. 290 key recommendations were made for healthcare regulators, providers and government to improve services in order to provide safe, high quality health care for all (Francis, 2013).

The Department of Health and Social Care (DHSC) (2016) focusses its drive to continually improve the quality of care whilst also managing the financial sustainability of the NHS. To support this the NHS devised a shared delivery plan known as the Five Year Forward View, their objectives are to reduce costs by £22 billion which will be reinvested in front line services (Gov.UK, 2015). The Quality Innovation Productivity and Prevention (QIPP) programme into how the NHS proposes to make those savings whilst continuing to improve the quality of care the NHS delivers. Arguably, The Royal College of Nursing (RCN) (2012) are concerned that short term savings are at the expense of the long-standing service change needed to meet the challenges of an ageing population, they further describe their concern for the damage it may be doing to patients today and in the future. Similarly, (CQUIN) (2018), more commonly known as Commissioning for Quality and Innovation, is a framework which aims to continually improve quality and drive innovation, it is incentive based to encourage service providers to achieve targets in exchange for financial payment. This system drives forward productivity, beneficial in any establishment.

It is also through continued SI that the NHS has been able to respond successfully to the growing population, the sicker population as well as the ageing population. Statistics show that even with such a growing population the percentage of the general public being satisfied with the NHS has dou