A “tsunami of anger” is heading towards the NHS unless organisations start to engage more fully with the public, the chairman of the Mid Staffordshire Foundation Trust public inquiry has warned.

During comments marking the close of the last of a series of seminars organised by the inquiry to inform its recommendations, Robert Francis QC said the health service’s non-transparent mindset had to be “defeated.”

He highlighted the John Lewis chain’s approach to dealing with complaints, which the inquiry heard about during a seminar on patient experience. This involves staff being empowered to exercise their judgement if they think there is a better way of solving the problem that is outside the system.

Mr Francis said: “Within that package of information and openness and honesty and not being overwhelmed by systems it seems to me there is a lot of wisdom.

“There is a tsunami of anger heading towards the NHS which will overwhelm people paddling in their canoes acting as if nothing is happening.”

The final seminar examined commissioning and featured presentations from Nuffield Trust’s Judith Smith and David Colin-Thome who carried out an initial report on lessons for commissioners from what happened in Mid Staffordshire.

Dr Colin-Thome suggested providers and commissioners should share the responsibility for their populations with commissioners able to challenge clinical leadership directly in organisations they buy services from. He said the NHS focused too much on technical skills rather than leadership attributes when appointing its leaders and pointed to the variable standards within the trust as evidence the situation was a failure of management.

The seminar was also attended by Future Forum chair Steve Field, executive member of the National Association of Primary Care Charles Alessi, NHS Midlands and the East joint commissioning development lead Paul Zollinger-Read and about 20 other high profile GPs and commissioners.

Concluding the day, Mr Francis said: “I have heard a lot about the power balance within the NHS and the perception at least that perhaps power rests within the provider trusts because it’s too difficult to press the nuclear button and leave communities without care.

“A question I may have to look at is whether it is to some extent an omission to look for appropriate levers but also putting things into the ‘it’s all too difficult box’. If new commissioning arrangements are to mean anything at all I would hope they mean if there is a power imbalance it’s redistributed.”

Closing statements to the inquiry, which has been hearing evidence for more than a year, begin on 21 November and are scheduled to last for two weeks. The inquiry will report next year.