Recommendations: Mid Staffs Inquiry

The Care Quality Commission and/or Monitor should keep the accuracy, fairness and balance of quality accounts under review and should be enabled …

It is important that the appropriate steps are taken to enable properly anonymised data to be used for managerial and regulatory purposes.

The information behind the quality and risk profile – as well as the ratings and methodology – should be placed in the …

While there are likely to be many different gateways offered through which patient and public comments can be made, to avoid confusion, …

Results and analysis of patient feedback including qualitative information need to be made available to all stakeholders in as near "real time" …

A proactive system for following up patients shortly after discharge would not only be good "customer service", it would probably provide a …

The Information Centre should be tasked with the independent collection, analysis, publication and oversight of healthcare information in England, or, with the …

The Information Centre should continue to develop and maintain learning, standards and consensus with regard to information methodologies, with particular reference to …

The Information Centre, in consultation with the Department of Health, the NHS Commissioning Board and the Parliamentary and Health Service Ombudsman, should …

The standards applied to statistical information about serious untoward incidents should be the same as for any other healthcare information and in …

The Information Centre should be enabled to undertake more detailed statistical analysis of its own than currently appears to be the case.

All healthcare provider organisations, in conjunction with their healthcare professionals, should develop and maintain systems which give them: Effective real-time information on …

It must be recognised to be the professional duty of all healthcare professionals to collaborate in the provision of information required for …

In the case of each specialty, a programme of development for statistics on the efficacy of treatment should be prepared, published, and …

The Department of Health, the Information Centre and the Care Quality Commission should engage with each representative specialty organisation in order to …

In designing the methodology for such statistics and their presentation, the Department of Health, the Information Centre, the Care Quality Commission and …

All such statistics should be made available online and accessible through provider websites, as well as other gateways such as the Care …

Resources must be allocated to and by provider organisations to enable the relevant data to be collected and forwarded to the relevant …

The only practical way of ensuring reasonable accuracy is vigilant auditing at local level of the data put into the system. This …

There is a need for a review by the Department of Health, the Information Centre and the UK Statistics Authority of the …

To the extent that summary hospital-level mortality indicators are not already recognised as national or official statistics, the Department of Health and …

There is a demonstrable need for an accreditation system to be available for healthcare-relevant statistical methodologies. The power to create an accreditation …

The terms of authorisation, licensing and registration and any relevant guidance should oblige healthcare providers to provide all relevant information to enable …

There is an urgent need for unequivocal guidance to be given to trusts and their legal advisers and those handling disclosure of …

It is of considerable importance that independent medical examiners are independent of the organisation whose patients' deaths are being scrutinised.

Sufficient numbers of independent medical examiners need to be appointed and resourced to ensure that they can give proper attention to the …

National guidance should set out standard methodologies for approaching the certification of the cause of death to ensure, so far as possible, …

It should be a routine part of an independent medical examiners's role to seek out and consider any serious untoward incidents or …

So far as is practicable, the responsibility for certifying the cause of death should be undertaken and fulfilled by the consultant, or …

Both the bereaved family and the certifying doctor should be asked whether they have any concerns about the death or the circumstances …

It is important that independent medical examiners and any others having to approach families for this purpose have careful training in how …

Coroners should send copies of relevant Rule 43 reports to the Care Quality Commission.

Guidance should be developed for coroners' offices about whom to approach in gathering information about whether to hold an inquest into the …

The Lord Chancellor should issue guidance as to the criteria to be adopted in the appointment of assistant deputy coroners.

The Chief Coroner should issue guidance on how to avoid the appearance of bias when assistant deputy coroners are associated with a …

Impact and risk assessments should be made public, and debated publicly, before a proposal for any major structural change to the healthcare …

The Department of Health should together with healthcare systems regulators take the lead in developing through obtaining consensus between the public and …

The Department of Health should ensure that there is senior clinical involvement in all policy decisions which may impact on patient safety …

Department of Health officials need to connect more to the NHS by visits, and most importantly by personal contact with those who …

The Department of Health should promote a shared positive culture by setting an example in its statements by being open about deficiencies, …