Senior NHS leaders have warned ministers not to impose "excessive inspection or micromanagement" on hospitals that could be counter-productive in the wake of a damning report to be published this week.
The Francis report into the catastrophic failings that led to the unnecessary deaths of up to 1,200 elderly patients at Stafford Hospital is expected to recommend sweeping changes to the way hospitals are inspected and changes to training for medical staff.
But the body that represents hospital managers has warned the Health Secretary, Jeremy Hunt, not to engage in a "simplistic blame game" or introduce yet another NHS shake-up at a time of unprecedented change.
The Department of Health has said it will carefully examine all the proposals put forward by the Francis report, to be published on Wednesday.
But there will be concern, both in Whitehall and the NHS, if Mr Francis recommends new minimum staffing levels on wards or costly training, inspection and appraisal systems on top of those which already exist.
Already the health service is struggling to implement a £20bn efficiency programme.
Mike Farrar, head of the NHS Confederation, said excessive inspection or micromanagement would suck up resources and fail to trigger the culture change necessary to prevent such failures recurring.
"Wednesday will be one of the darkest days for the NHS but we must turn it in to an opportunity to build a better NHS for patients," he said.
"We need to make it easier for patients to give feedback. We need to provide the public with a clearer picture of the performance of their local services. The people in charge of running our health services should rightly be held to account when they fail to act in the interests of patients.
"What we don't want is a simplistic blame game, excessive inspection or micromanagement.
"These suck up resources and encourage tick-box responses, not real culture change."
Ministers believe that their new "friends and family" test – where NHS staff are asked anonymously to say whether they would recommend their ward to a loved one – should help address issues of poor care.
This has already shown stark variations in standards. At the worst, 30 per cent of doctors, nurses and healthcare workers at Croydon Health Services NHS Trust in south London admitted they were so unhappy with the care provided that they would not want a relative or friend to be treated there.
At four other trusts, a quarter or more of the staff were equally concerned. They were Barking, Havering and Redbridge University Hospitals; Royal Cornwall Hospitals; South London Healthcare; and North Cumbria University Hospitals.
At the other end of the spectrum just 1 per cent of staff at Clatterbridge Cancer Centre NHS Foundation Trust in Merseyside would be unhappy with a loved one being treated there.
The Francis report is expected to blame a bullying management culture which resulted in hospitals focusing on meeting government targets while ignoring basic patient care. Among those who could be criticised is Sir David Nicholson, head of the new NHS Commissioning Board who was previously chief executive of Shropshire and Staffordshire Strategic Health Authority, which covered Mid Staffordshire.
Relatives of those who died at the Mid Staffordshire Trust are due to meet David Cameron at Downing Street on Monday. They want an assurance that he will implement the recommendations of the public inquiry.
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