In his report into the lessons to be learned from the failures at Mid Staffordshire foundation trust, national primary care director David Colin-Thomé concluded that responsibility lies firmly with the management board and staff.

In HSJ’s snapshot survey this week into what changes acute trusts had made since the Mid Staffordshire scandal became public, the picture that emerges is one of managers and acute trust directors who have taken note of what happened and, more importantly, are taking steps to ensure it does not happen again.

The vast majority have read the Healthcare Commission report and considered its implications for their own trust.

Reassuringly, they are not all making the same changes - knee-jerk reactions seem to have been avoided. Not all trusts must focus on the same areas for improvement as Mid Staffordshire, or indeed each other. The significant thing is that they have considered what lessons can be learned and, most importantly, which ones apply to them.

However, Care Quality Commission chair Baroness Young tells HSJ this week that the new regulator does not favour similar high profile reports into failures: she sees them as a “bit of a blunt instrument” and wants organisations to take responsibility rather than be “bludgeoned into change”.

She is giving trusts the benefit of the doubt. But some may not deserve it. The Audit Commission last week said many NHS boards could not even be sure their trusts were operating within the law.

So while ministers and managers alike stress how uncommon was the situation at Mid Staffordshire, the next step is to prove that it does not take another “one-off” scandal to prompt improvement - it must be routine.

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