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I have now read the report, and I'm afraid to say there was a lot of what appears like simply going through the motions, but ensuring the outcome only led to one favoured conclusion. There were a number of pointers to such inclination in the report: such as confirming for instance, that the trust did have capacity problems, and yet insisting it should have been able to cope with increased demands without showing how this would be possible in the circumstance. The report also kept referring to reviews conducted by various external bodies post events suggesting there were no serious patient safety issues in the Trust, as evidence that Dame Hakin's insistence that targets be met posed to patient safety risk.

It seems the investigators failed to recognise the patient safety risks were inherent in the overriding pressure to meet targets, and not the reality at the frontline afterwards particularly when the CEO had in fact resisted such offending pressure. Worse still was the fact that when the CEO and Chairman then presented evidence from frontline staff of patient safety and mortality issues, they rejected this saying it had no causal link with Ms Hakin's pressures. Seems hypocritical then for the GMC investigators to attach so much relevance to external reviews of the trust, as the causal link rebuttal might just as well apply, had the external reviews including CQC's confirmed patient safety problems.

If NHS leaders continue to act without integrity, and to indulge the management bullying culture at high costs to patients and staff, they should be under no illusions that the Francis proposed criminal liability for serious harm or death to patients would be more than justified in these circumstances.