Intended for healthcare professionals


Safeguarding NHS standards

BMJ 2009; 338 doi: (Published 13 May 2009) Cite this as: BMJ 2009;338:b1958
  1. Rudolf Klein, visiting professor
  1. 1London School of Economics, London WC2A 2AE
  1. rudolfklein30{at}

    Professional responsibility matters more than conforming to process

    The inquiry of the Healthcare Commission into the failure of the Mid Staffordshire NHS Foundation Trust to provide adequate care for its patients continues to reverberate through the NHS.1 Its publication in March has been followed by a succession of other reports, policy statements, and promises by regulators to do better in future. And rightly so, since the case suggests a wider systems failure.

    None of the bodies who might have been expected to sound the alarm about poor standards of care come out of the affair with their reputation intact. Once satisfied about the trust’s financial affairs, Monitor, the independent regulator of NHS foundation trusts, happily accorded foundation trust status to Mid Staffordshire at the beginning of 2008, relying on the Healthcare Commission’s 2007 rating of the hospital as “good-fair.” The Healthcare Commission launched its investigation into mortality rates at the trust in March 2008, but ignored earlier hints provided by staff and patient surveys that all might not be …

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