Healthcare Commission enquiry Recommendations Recommendations (19) Grave failure of patient protection - change in leadership Actions by managers to control risk of infection 1-3 Infection control and training Standards of care 4-7 Clinical care, patient dignity, transfer, clinical decision dissemination Staffing 8 Levels and training for safe care Clinical governance and risk management 9-13 Clinical risk management including infection control Handling and learning from complaints 14 Serious complaint investigation and management responsibility of board National responsibilities 15-19 NHS, HPA, DH
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