We accept the findings of Robert Francis QC’s public inquiry, Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, February 2013, that at every level of the healthcare system, there was a failure to put the needs and safety of patients first, and to act on the warning signs that there were significant problems at the Trust.

However, we believe that the Trust Board were ultimately accountable for the poor standards of care delivered under their management. As the Inquiry stated, “the Trust prioritised its finances and its Foundation Trust application over its quality of care”.

On November 19, the Government published its full response to the Inquiry, Hard Truths: the Journey to Putting Patients First, November 2013. A copy has already been placed in the Library. The measures set out in this will together put in place the action needed to revitalise the culture of the National Health Service around a consistent focus on the needs of the patients it serves.

This includes:

— A robust inspection regime, with physical inspection by experts, considering whether services are safe, effective, caring, responsive to people’s needs and well-led;

— A new failure regime based on quality as well as finance, which will allow much swifter intervention to put things right;

— Monthly transparency on staffing levels, falls, pressure sores, complaints and other key indicators which will provide a smoke alarm locally and nationally, if things are not right;

— A new criminal offence of providing certain types of false or misleading information and a new statutory duty of candour which will set clear expectations around openness and honesty;

— A fit and proper persons test for Board directors, so that those responsible for failures in care are prevented from working elsewhere in the system; and

— Where breaches of the new fundamental standards take place, the Care Quality Commission will ultimately have the powers to prosecute and there will be much stronger accountability for managers—for quality as well as finance.

The right way to meet the objective of enhanced candour by individuals is by strengthened references to candour in professional regulation. This will include being candid with patients when mistakes occur whether serious or not, and reporting “near misses” for errors that could have led to death or serious injury, as well as actual harm. Alongside this, the organisational duty of candour will drive a more open culture throughout organisations, including its staff.

Under the Health and Social Care Act, general practitioner (GP) practices are required to provide information to the Health and Social Care Information Centre in circumstances specified in the Act. Patients do not have any legal right to prevent this but the Secretary of State has directed that any objections raised by patients should be respected as a matter of policy.

Patients can let their GP practice know if they want to object to confidential information held in their GP's system from being shared or used for any other purpose other than providing their care, except where required by law. Patients can also object to information collected nationally by the Health and Social Care Information Centre from being shared with others where it identifies them.