Preceded by several days of slightly fevered media coverage, the Francis Report was finally published in the first week of February.1 Its breadth is wide, its analysis is forensic in detail, its findings are embarrassing (to put it mildly) and its recommendations (all 290 of them) are game changing. If implemented, Francis will have a bigger impact on the NHS than Kennedy did after Bristol. It makes compelling reading.

Here are a few snippets (from the section listing the inquiry's findings) that are of immediate interest to us:

• Hospital consultants at Stafford were not at the forefront of promoting change. Clinicians did not pursue management with any vigour with the concerns they may have had. Many kept their heads down. A degree of passivity about difficult personnel issues is all too common in the NHS as, perhaps, elsewhere.

• The national general acceptance of the importance of clinical governance had failed to permeate sufficiently into Stafford to result in a functioning, effective system; the Trust was operating in an …