1. Similarities between the Macchiarini-and the Mid Staffordshire scandal
Leaders were informed but did not act
An institutional culture which ascribed more weight to positive information than to information capable of implying cause for concern
Whistleblowers were punished
Media played an important role in revealing the scandal

2. Recommendations
Foster a common culture shared by all in the service of putting the patient first
Ensure openness, transparency and candour throughout the system about matters of concern

3. Openness, transparency and candour
Openness – enabling concerns and complaints to be raised freely without fear and questions asked to be answered.
Transparency – allowing information about the truth about performance and outcomes to be shared with staff, patients, the public and regulators.
Candour – any patient harmed by the provision of a healthcare service is informed of the fact and an appropriate remedy offered, regardless of whether a complaint has been made or a question asked about it.