A common culture

The inquiry identified negative aspects of culture in the health and care system. These included:


  • misplaced assumptions in organisations about the judgements and actions of others

  • an acceptance of poor standards

  • a failure to put the patient first in everything that is done


To remedy this, the inquiry recommended a change in culture, with a relentless focus on patients’ interests, keeping patients safe, with no tolerance of substandard care.

Frontline staff need to be empowered to act to achieve this. In order for them to be empowered to do so, they need strong and stable leadership. To enable this, the inquiry recommended the introduction of a set of readily accessible standards that providers must comply with, and readily accessible means of complying with those standards.

In response to these recommendations, the Department of Health, the National Institute for Health and Care Excellence, NHS England and the Care Quality Commission (CQC) are working together on a new framework of standards.

New regulations, upon which the department will consult widely, will set out fundamental standards of care that will come into effect during 2014. Through its chief inspectors, the CQC is engaging with providers, professionals and the public on what guidance it should publish on complying with these regulations, and how they should relate to the CQC’s broader assessments of the quality of services.

The new fundamental standards of care will give a clearer focus on governance requirements, which will be reflected in the CQC’s new approach to inspection.

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