The Government must "avoid wholesale reorganisation" of the NHS following the damning report into failings of care at Stafford Hospital, according to its author.
Robert Francis QC, who led the public inquiry into Mid Staffordshire NHS Foundation Trust, uncovered failings at every level of the NHS and said the culture among healthcare staff must change. His comments come as it emerged there were 3,000 more deaths than expected at another five NHS trusts between 2010 and last year.
NHS Commissioning Board medical director Professor Sir Bruce Keogh has now launched a review into those trusts.
Meanwhile Mr Francis, speaking ahead of a public meeting with the families of former patients at Stafford Hospital, said: "What we need to avoid is yet another wholesale reorganisation of abolishing organisations and creating new ones. This is about how people behave when they go to work and their ability to raise concerns and be honest about what's going on in their hospitals."
He said the change would only happen when NHS managers, clinicians and staff started to address the failings "rather than waiting to be told what to do from Whitehall, or by the top of the NHS".
The inquiry into Stafford Hospital's unusually high death rate among patients uncovered a "disaster" in the standards of basic care and medical treatment for some of the most vulnerable and elderly patients. He said none of the 290 recommendations covered in his report "have been made lightly" and hoped all would be adopted in full.
"What we're looking at is the challenge of changing an institutional culture where the importance of corporate governance and financial control was put ahead of looking after patients," he said. "We need fundamental standards which will have criminal sanctions applied to serious breaches of those standards."
He said the law should act against anyone in the NHS who "gets in the way" of staff reporting their concerns. "We need to have leadership that signs up to and exemplifies putting patients first and takes the lead in that," he said.
Mr Francis said it was vital nurses, doctors and staff had the support to make the NHS "honest" and adopt a culture of transparency.
Speaking before a private meeting with Mr Francis at Stafford, patients' campaigner Julie Bailey, whose elderly mother Bella died at the hospital, called for individuals at the NHS to be held accountable for the failings in care. She said: "This is an opportunity to put down the gauntlet and say enough is enough. From today you will be held accountable for your actions - it's no good saying in the future you will be held accountable."
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