Concerns about mortality and the standard of care provided at the Mid Staffordshire NHS Foundation Trust resulted in an investigation by the Healthcare Commission which published a highly critical report in March 2009, followed by two reviews commissioned by the Department of Health. These investigations gave rise to widespread public concern and a loss of confidence in the Trust, its services and management. This Inquiry was set up primarily to give those most affected by poor care an opportunity to tell their stories and to ensure that the lessons learned were fully taken into account in the rebuilding of confidence in the Trust. The evidence received about the patient experience covered many areas of basic nursing and medical care, communication and discharge management. The culture of the Trust was not conducive to providing good care for patients or providing a supportive working environment for staff due to: attitudes of patients and staff; bullying; target-driven priorities; disengagement from management; low staff morale; isolation from the wider NHS community; lack of openness; acceptance of poor standards of conduct; reliance on external assessments; and, denial. The report also looks at the management of significant issues - ward reconfiguration, finance, staff cuts - governance, staff review, the Board, mortality statistics and external organisations. Major themes identified by the Inquiry are: focus on process not outcomes; failure to listen to complaints; insufficient attention to maintenance of professional standards; lack of support for staff; failure to meet the challenge of care for the elderly; lack of transparency; and, disregard of the significance of mortality statistics.
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