Families of patients who died at the failure-ridden Stafford Hospital have called for heads to roll at the NHS, as the head of the inquiry into "appalling" failings at its Trust said there should be a "zero tolerance" approach to poor standards in the health system.
Julie Bailey, head of Cure the NHS, said Robert Francis QC's report would give patients "power", but called for the resignation of NHS chief Sir David Nicholson, as well as Royal College of Nursing chief executive Peter Carter.
Speaking after the publication of the report, which made 290 sweeping recommendations, Miss Bailey said: "We don't want a bully at the top of this organisation, we want a leader who will inspire and guide the staff on the front line.
"Sir David Nicholson needs to resign today. Peter Carter needs to resign today, he has failed the front line.
"We want resignations, we are going nowhere.
"We have lost hundreds of lives within the NHS, we want accountability."
She said Mr Francis' report had not made campaigners angry, but added: "Everything in this report is what we need, this will give patients power.
"But it needs a leader to take that forward, and David Nicholson is not that leader."
Prime Minister David Cameron said what happened at Mid Staffordshire NHS Foundation Trust was "not just wrong, it was truly dreadful".
He apologised on behalf of the Government and country for the way the system had allowed "horrific abuse to go unchecked and unchallenged" for so long.
Mr Cameron also said the report's evidence of systemic failure means "we cannot say with confidence that failings of care are limited to one hospital".
He added: "We can only begin to imagine the suffering endured by those whose trust in our health service was betrayed at their most vulnerable moment."
Mr Cameron announced he had ordered the creation of the post of Chief Inspector of Hospitals, who will have responsibility for an inspection regime which will investigate "whether a hospital is clean, safe and caring, rather than just an exercise in bureaucratic box-ticking".
An immediate investigation will be carried out by Sir Bruce Keown into the standards of care at hospitals which currently have the highest mortality rates.
And changes will be made to the failure regime for NHS trusts, to ensure that the suspension of a board can be triggered by failures in care, and not just financial failings, as at present, said Mr Cameron.
Mr Cameron told the Commons: "I would like to apologise to the families of all those who suffered from the way the system allowed this horrific abuse to go unchecked and unchallenged for so long.
"On behalf of the Government and indeed our country, I am truly sorry."
Publishing the 1,782-page report, Mr Francis suggested widespread changes set to affect the whole NHS, which he said had failed to protect patients.
There was a failure to communicate between the plethora of regulatory agencies and "too great a degree of tolerance of poor standards", he said.
He called for a change of culture, and for breaches of standards to become criminal offences.
Mr Francis avoided blaming individuals or "scapegoats".
He said fundamental standards should be policed by a single regulator - the Care Quality Commission (CQC), and said the regulator Monitor should be stripped of its powers to award trusts foundation status - a supposed marker of excellence.
Monitor awarded the trust foundation status while the care failings were taking place.
The trust failed to tackle an "insidious negative culture" including a tolerance of poor care standards, and had a culture of "self-promotion rather than critical analysis and openness", the report said.
Other organisations also failed to uncover concerns, and there was a failure "at every level" to communicate concerns with others and to take sufficient action to protect patient safety.
"In short, the trust that the public should be able to place in the NHS was betrayed," Mr Francis said.
He said there should be an increased culture of compassion and caring in nursing and recommended that there should also be a legal obligation for healthcare providers and medics to observe a "duty of candour".
Speaking as the report was published, Mr Francis said: "This is a story of appalling and unnecessary suffering of hundreds of people.
"They were failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety.
"I have today made 290 recommendations designed to change this culture and make sure that patients come first.
"We need a patient-centred culture, no tolerance of non-compliance with fundamental standards, openness and transparency, candour to patients, strong cultural leadership, caring compassionate nursing, and useful and accurate information about services."
His wide-ranging recommendations included laws to back up standards, saying: "To cause death or serious harm to a patient by non-compliance with fundamental standards should be a criminal offence."
He said procedures and ways of assessing standards should be produced by the National Institute for Health and Clinical Excellence (Nice), including guidance on staffing, and support and protection for whistleblowers.
Standards should be policed by the Care Quality Commission (CQC), he said, including physical inspections as the most effective way of checking standards.