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Alistair is right. Tabloid lynchings are not helpful or humane, but there are some senior teams who have simply failed. There are no excuses, but just because they've failed doesn't mean there's no way out of the cold.

If there's one lesson we have to learn, it's that nursing is not something to take for granted because it makes such a massive difference to the safety & decency of patient care.

As Anonymous | 17-Jul-2013 8:29 am points out, impression management & covering up understaffing and poor care has led to this. I know because I worked in just such a Trust and with such incompetent managers. We can all see the results.

I'd have liked some of the answers and management support to have come from nursing itself, but looking at the NMC and RCN, this seems miserably unlikely.

The first thing these Trusts need to do is take a hard look at their senior nursing team and make sure it's fit for purpose and ensure that they're staffing all clinical services with Real Nurses, not just HCAs or agency staff, every day and every night your services are available.

Then set up monthly reporting on a set of robust clinical outcomes and focus on complaints and risk issues. Don't stop till you are 100% sure that each of these issues are dealt with, but check anyway. Get your nurse director working alongside the staff teams and reporting directly & fully to you.

Nursing isn't like heat and lighting - you can't just pay the bill and take the quality for granted. You need to know it's effective because your job truly depends on it.