A STAFFORDSHIRE hospital trust, where hundreds more patients than expected died, had a "shocking" and "appalling" system for looking after people admitted to A&E, a damning report said today.

Between 400 and 1,200 more people died than would have been expected at Mid Staffordshire NHS Foundation Trust over three years, the report said.

Although it is not clear how many of these deaths could have been avoided, the Healthcare Commission said patients undoubtedly suffered as a result of lapses in the standard of care.

Its investigation, based on more than 300 interviews and an examination of over 1,000 documents, found inadequately trained staff who were too few in number, junior doctors left alone in charge at night, and patients left without food, drink or medication as their operations were repeatedly cancelled.

Some patients were left in pain or needing the toilet, sat in soiled bedding for several hours at a time and were not given their regular medication, the Commission heard.

Receptionists with no medical training were expected to assess patients coming in to A&E, some of whom needed urgent care.

Sir Bruce Keogh, medical director of the NHS, said there had been a "gross and terrible breach of trust" of the patients the NHS seeks to serve.

He said the Healthcare Commission's report showed there had been a "complete failure of leadership" at the Trust.

He added: "I'm proud of the NHS but actually I'm really saddened by this report."

Patients accepted there were risks involved in treatments and procedures, but they did not accept that those people who should be helping them would let them down and that the system caring for them would be "faulty", he said.

Earlier this month the Trust's chief executive, Martin Yeates, and chairman, Toni Brisby, resigned.

The Healthcare Commission's chairman Sir Ian Kennedy said the investigation followed concerns about a higher than normal death rate at the Trust.

Those in charge of the Trust failed to give an adequate explanation of these figures, prompting the Commission to launch a full investigation.

He said: "The resulting report is a shocking story.

"Our report tells a story of appalling standards of care and chaotic systems for looking after patients.

"These are words I have not previously used in any report.

"There were inadequacies in almost every stage of caring for patients.

"There was no doubt that patients will have suffered and some of them will have died as a result."