- guardian.co.uk, Wednesday 24 February 2010 17.19 GMT
Relatives of those who have died at Stafford general hospital stand in front of a tribute wall. The hospital left patients in pain, says an inquiry. Photograph: Rui Vieira/PA
An independent inquiry found today that there were "shocking" systematic failures of hospital care in Mid Staffordshire that left patients routinely neglected, humiliated and in pain as the trust focused on cutting costs and hitting government targets.
Today's report from the inquiry led by Robert Francis QC, which was commissioned by the health secretary, Andy Burnham, concluded with 18 recommendations for the trust and the government, but was criticised by some families who reiterated calls for a full public inquiry.
The Francis inquiry was commissioned in last September after a damning investigation by the Healthcare Commission six months earlier, which found that between 400 and 1,200 more people died at the Mid Staffordshire NHS Foundation Trust than at other hospital trusts between 2005 and 2008.
The appalling picture painted by the commission - which described how some patients drank water from vases because they were so thirsty and how many had to rely on their families for food - was not exaggerated, Francis said today.
His inquiry heard evidence from some 900 patients and families, finding that many patients "suffered horrific experiences that will haunt them and their loved ones for the rest of their lives ... There can no longer be any doubt as to the enormity of what occurred".
Francis found that for many patients the most basic elements of carewere neglected while others were left humiliated and sobbing. The report found that:
• Patients were left in sheets soiled with urine and faeces for considerable periods of time.
• There was striking evidence of the incidence of falls suffered by patients, some of which led to serious injury. Many took place unobserved by staff
• The attitude of nursing staff left much to be desired
• Relatives took to taking sheets home to wash
• There was insufficient care for patients' dignity, with some left in degrading conditions and others inadequately dressed in view of passersby
• Families were forced to remove used bandages and dressings from public areas and clean toilets themselves for fear of catching infections.
Gordon Brown described the management failure at the trust, which hit targets and achieved elite foundation status, as completely unacceptable and said the government was working on plans to strike offhospital managers responsible for such issues.
The Tory health spokesman Andrew Lansley castigated the government's "tick box" culture and underlined his party's backing for a public inquiry.
Julie Bailey, who founded the campaign group Cure the NHS after the death of her mother at the hospital, described the report as "absolutely outrageous". "All he's done is recommended another independent inquiry," she said.
The families also complained that evidence to the Francis inquiry was not given in public.
Many staff had expressed concerns about the situation at the trust. "The tragedy was that they were ignored," Francis said. "I suggest that the board of any trust could benefit from reflecting on their own work in the light of what is described in my report."
The Care Quality Commission, which has replaced the Healthcare Commission, said Mid Staffordshire was now safe to provide hospital services but it would ensure standards were met.
Jo Williams, the commission's interim chairwoman, said: "The experiences people describe in this report are deeply distressing and totally unacceptable. There is no excuse for the appalling care patients suffered in this trust and everything possible must be done to prevent this from ever happening again in any NHS trust.
"It is important to understand that the scale of change required in this organisation was very significant and was never, therefore, going to happen overnight. This is why we have been scrutinising the trust's performance rigorously over the past 12 months.
"What we currently see is a picture of progress. But in the areas in which we have continuing concerns, we need to ensure that the trust delivers on what it says it is going to do. We need to see that these improvements are delivered on the ground for patients."
Burnham said: "This was an appalling failure at every level of the hospital to ensure patients received the care and compassion they deserved. There can be no excuses for this. I am accepting all of the recommendations in full and will set out a detailed response to parliament later today.
"This was ultimately a local failure, but it is vital that we learn the lessons nationally to ensure that it won't happen again. We expect everyone in the NHS to read the report and act on it. These events were unacceptable and do not reflect the experience of millions of patients that use the NHS every day or the dedication and professionalism of the majority of NHS staff."