The latest report into the major failings at the Mid Staffordshire Trust and its hospital has stopped short of blaming Sir David Nicholson, the chief executive of the NHS.

The Francis inquiry, which was published on Wednesday, is the fifth major investigation into the Staffordshire Hospital scandal.

Data showed that there were between 400 and 1,200 more deaths than would have been expected between 2005 and 2008 at the hospital, prompting a series of inquiries.

This week’s report condemned what it saw a ‘business like’ culture in the NHS, which put box ticking ahead of patients, and warned that the entire culture of the health service needed to be reformed.

But in its 1,700 plus pages, Mr Francis made no mention of Sir David Nicholson, who had oversight of the Trust’s area during its darkest period, which has angered the family members of those who have died. They met with the Francis QC yesterday to discuss the report, and the role of senior individuals in the Trust and hospital’s failure.

James Duff, whose wife, Doreen, died in the hospital, told the BBC that it had been a “disaster” but “nobody is accountable”.

He added: “Not one person has lost their job over this - instead they have been promoted and some people have been moved sideways,” he said.

In fact so strong is the feeling that a member of the public recently launched an official e-petition to force Sir David Nicholson to resign – if the online signatures reach over 100,000, the UK Government will have to debate the issue in Parliament. 

Nicholson ‘considered resigning’

Sir David has now apologised to the people of Staffordshire, and said that after the first Francis report in 2010, he had considered resigning his post. He has said since, however, that he is no longer considering stepping down.

Both the Prime Minister and health secretary Jeremy Hunt said they had confidence in Sir David’s ability to stay in charge, with Cameron telling the Commons on Wednesday it would be “wrong to make him a scapegoat”.

Sir David said it was “perfectly understandable” that some were calling for his resignation. “I understand the anger that they feel”, he said, “the upset that they feel about the treatment of their loved ones in Mid-Staffordshire hospital.”

He added: “I absolutely understand all of that. At the time I apologised and in a sense I apologise again to the people of Stafford for what happened, but apologies are not enough. We need action; we need to make things happen.”

Since 2005 Sir David he has made a meteoric rise to become arguably the most powerful man in the NHS – first as its chief executive in 2007 and from April, as head of the new NHS Commissioning Board, which will have control of the majority of the NHS’s £105 billion budget. 

The Board will be responsible for the 227 GP-led Clinical Commissioning Groups, which will also in April become the new commissioners for the NHS, taking over from the abolished Primary Care Trusts and Strategic Health Authorities.