The era of NHS patients being shunted around hospitals needs to end, an expert group says.
The Future Hospital Commission - set up by the Royal College of Physicians - said a radical revamp in structures was needed to bring care to the patient.
This was particularly true for frail people with complex needs, who often faced multiple moves once admitted to hospital, the report said.
It also recommended closer working with teams in the community.
The commission said this could involve doctors and nurses running clinics in the community and even visiting people in their own homes - as is already happening in a few places.
'Bold and refreshing'
It also called for an end to the concept of hospitals discharging patients.
Sir Mike Rawlins: "Hospital shouldn't stop at the walls of the building"
Instead, it argued that many of those seen in hospitals in the 21st Century needed ongoing care that did not end when they left hospital.
So the report recommended that planning for post-hospital care should happen as soon as someone is admitted.
Key to that will be a new hub that should be created in every hospital, called a clinical co-ordination centre, which would act as a central control room, helping to ensure information about patients is shared and their care planned properly.
Once in hospital, patients should not move beds unless their care demanded it, the report said.
That contrasts with the multiple moves many patients with complex conditions often find themselves facing as they are passed from specialism to specialism.
It said this would require a greater emphasis on general wards with specialists visiting patients rather than the other way round.
The longest Suzie Hughes, who has the auto-immune condition Lupus, has spent in hospital is 21 days.
During her stay, she was moved five times for non-clinical reasons.
"I would find myself being wheeled down the corridor with my flowers and chocolates. Nurses would be with me and I kept thinking, 'What a waste of their time.'
"And each time I arrived on a new ward I had to explain my condition again. The information does not get passed on and it results in delays."
The authors - drawn from across the NHS and social-care spectrum - also called for an end to the two-tier weekday and weekend service in many facilities.
They even said it would be preferable to work at 80% capacity across the seven days if extra resources were not available in the short-term.
Commission chairman Sir Michael Rawlins said it was about providing the care patients "deserved".
Alzheimer's Society chief executive Jeremy Hughes said too often hospitals were stressful places with patients being moved "from pillar to post".
"We need nothing less than a revolution... in order to ensure our NHS is fit for the future," he added.
Health Secretary Jeremy Hunt said the report was "bold and refreshing".
"I agree completely that we must make services more patient-centred both inside and outside hospital."
Shadow health secretary Andy Burnham said: "We must turn this system around and help support people where they want to be - at home with their family around them."
Duty of candour to be placed on NHS boards to be honest about mistakes.
Consideration being given to making individual doctors and nurses criminally responsible for covering up errors.
New ratings system for hospitals and care homes based on Ofsted scheme used in schools.
Posts of chief inspector of hospitals and care homes to be created.
Nurses to spend up to a year working as a healthcare assistant so they get experience providing basic care such as washing and dressing in pilot schemes.
Managers who fail in their jobs to be barred from holding such positions in the future.
Code of conduct and minimum training standards for healthcare assistants, but not full registration scheme as recommended by inquiry.
Tough rules to be drawn up to allow trusts to be put into administration when basic standards are not met unless problems can be resolved quickly.
Department of Health civil servants to be forced to spend time on the front line of the NHS.
"We cannot merely tinker around the edges - we need a radical overhaul with high quality care and compassion at its heart."
He said he wanted to create a culture of "zero harm" through the changes.
Key to this will be the new post of chief inspector of hospitals - announced immediately after the publication of the public inquiry - and the statutory duty of the NHS to be honest about mistakes, known as a duty of candour.
But the government said it would wait before deciding whether to make individual doctors and nurses criminally accountable for hiding mistakes as recommended by the inquiry as it was concerned about creating a "culture of fear".
The government has also stopped short of the inquiry's demand for a registration system for health care assistants.
Instead, it confirmed it will push ahead with a code of conduct and minimum training standards.
On training for nurses, ministers said there would be a pilot programme whereby nurses will have to work for up to a year as a healthcare assistant before getting NHS funding for their degree.
Meanwhile, managers who fail in their jobs will be barred from holding such positions in the future.
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The ratings system, which will start being rolled out later this year, will be based on the Ofsted system used in schools.
Hospital and care homes will be given an outstanding, good, requiring improvement or poor rating.
However, in hospitals individual departments will be given their own rating as well to reflect the increased complexity of the organisations.
But shadow health secretary Andy Burnham said the culture of the NHS would not be changed unless staffing problems were resolved first.
"We will never get the right culture on our wards if they are understaffed and overstretched," Mr Burnham said.
Royal College of Nursing general secretary Peter Carter agreed staffing was an issue and said he was disappointed there would not be a registration system for healthcare assistants.
He also said he had concerns about the measures on nurse training, but added the the union was still "committed" to working with government to ensure a "patient-centred NHS becomes a reality".
But Don Redding, policy director of the patient group National Voices, felt the changes would make a difference, particularly the duty of candour.
"In cases where patients have been harmed or worse, both senior managers and their legal advisers have generally decided their first duty is to the interests of the trust. This new legal duty will rebalance that."
Mike Farrar, chief executive of the NHS Confederation, which represents health trusts, said: "The government has used this time to produce an overarching response rather than a something which tries to tick all the boxes.
"The response finds the right balance between external assurance measures and internal changes focused on transforming the NHS culture."
Robert Francis QC, who chaired the public inquiry, added: "Even though it is clear that it does not accept all my recommendations, the government's statement indicates its determination to make positive changes to the culture of the NHS."
Health Secretary Jeremy Hunt has warned NHS bosses against allowing a culture that is "legalistic and defensive" in dealing with staff who raise concerns over patient care.
In a letter to all English NHS trusts, Mr Hunt highlighted fears that "gagging" clauses were being used to "frustrate" such whistleblowing.
A climate of "openness and transparency" is essential, he said.
It comes after one former NHS trust boss broke a gag to talk to the BBC.
Gary Walker, former chief executive of United Lincolnshire Hospitals Trust (ULHT), said he had been forced out of his job and gagged from speaking out about his concerns over patient safety.
The row over secret gagging clauses has focused attention on the man at the top of the English NHS, Sir David Nicholson.
His position was already being questioned in the wake of a highly critical report on the Mid Staffordshire Hospitals scandal, where hundreds of patients may have died from neglect and abuse.
However Sir David escaped personal censure from inquiry chairman, Robert Francis QC.
Following the report, another 14 NHS trusts have been placed under investigation.
What makes the gagging row potentially so toxic for Sir David is one of those trusts, the United Lincolnshire Hospitals Trust, has been trying to enforce Gary Walker's gagging clauses with the threat of legal action.
Since Mr Walker broke cover, more people are asking whether Sir David and other senior NHS civil servants can bring about the cultural change and openness Jeremy Hunt and many others consider essential.
In his letter, Mr Hunt called for the NHS to "recognise and celebrate" staff who had "the courage and professional integrity to raise concerns over care".
The health secretary insisted that "fostering a culture of openness and transparency" was essential in creating a climate "where it is easy for staff, present and former, to come forward with any concerns they have relating to patient safety".
Mr Hunt also warned NHS bosses against the "institutional self-defence that prevents honest acknowledgement of failure".
"I would ask you to pay very serious heed to the warning from Mid Staffordshire that a culture which is legalistic and defensive in responding to reasonable challenges and concerns can all too easily permit the persistence of poor and unacceptable care," he said.
Mr Walker, who was sacked in 2010 for gross professional misconduct for allegedly swearing in a meeting, told the BBC he had no choice but to sign an agreement linked to a confidentiality clause in April 2011.
He said he was gagged by the NHS from speaking out about his dismissal and his concerns over the quality of care at the trust.
After breaking the order, lawyers for the trust then warned him he would have to repay £500,000.
Speaking to BBC Radio 4's Today programme on Saturday, Mr Walker applauded Mr Hunt for "clearly taking a personal interest" in his case and the issue of gagging orders.
"I think that's a very positive move."
"I don't think it's simply about the Lincolnshire Trust," he added, calling for Mr Hunt to investigate the "chain of command" that led to the gagging, which he said included the Department of Health, the East Midlands Strategic Health Authority (SHA) and the Lincolnshire Trust.
"I don't think Mr Hunt can investigate his own department so I think he should be looking for someone exceptionally independent from all of this."
'Suppressed and bullied'
BBC Radio 4 Today programme reporter Andy Hosken said Mr Hunt's letter could spell the end of the National Health Service gag if the NHS trusts' chairmen to whom he wrote actually followed the advice and guidance contained within the letter.
Our correspondent said the letter was certainly a warning shot across the bows of the trusts. It appeared the use of these gagging clauses was widespread in the NHS, he added.
Meanwhile, Dr Phil Hammond, chief medical correspondent at Private Eye magazine joined calls for NHS chief executive Sir David Nicholson to stand down.
He told BBC News: "We need to change the culture, we have to change the people at the top. David Nicholson has to go and that's the one constructive thing that Jeremy Hunt could do.
"Unless you have accountability at the top, you won't get it at the bottom."
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A spokesman for the East Midlands SHA said it had always acted "appropriately and properly" in the "interest of patients".
And ULHT has said the allegations that they had tried to stifle debate about patient safety issues were "incorrect".
ULHT is one of 14 trusts in England currently being investigated for high death rates, in the wake of the Stafford hospital scandal, where hundreds are believed to have died after receiving poor care.
It emerged on Friday that police and prosecutors are now studying a damning report into failures at Stafford to see whether any criminal charges should be brought against staff.
The deaths of patients at Stafford Hospital should be investigated by the police, the Health Secretary has said.
In an interview with the Daily Telegraph, Jeremy Hunt said it was "absolutely outrageous" that nobody had been "brought to book".
Staffordshire Police said it was currently "studying the report's full contents."
It said it had previously investigated two cases at the hospital but found no evidence to bring prosecutions.
"This was a public inquiry that was designed to help us understand why the system didn't pick up what went wrong but I think it is absolutely disgraceful with all those things happening, whether it is doctors, nurses or managers, nobody has been held to account," Mr Hunt told the newspaper.
'Duty of care'
He said that it was not for politicians to decide whether people should be prosecuted but that evidence should be reviewed.
The findings of the public inquiry into failings at Stafford Hospital were published on Wednesday.
Nurse Helene Donnelly left the hospital trust in 2008
The 12-month inquiry, which cost £13m, came after a higher-than-expected number of deaths at Stafford hospital between 2005 and 2008.
The report by Robert Francis QC strongly criticised hospital managers and the Department of Health.
Helene Donnelly worked as a staff nurse in the casualty department at Stafford Hospital and raised concerns about patient care about 100 times in six years.
She said there had been a culture of neglect at the hospital and that she was in favour of the evidence being looked at.
"As a nurse who went through it and saw some terrible things, I think there does need to be some accountability certainly with some of the nurses I spoke out against," she said.
Staffordshire Police said two cases of misdiagnosis had been formally investigated following patient deaths but no evidence was found to suggest the hospital had been negligent in its care.
Guido understands that Andy Burnham is about to be in some deep trouble. Yesterday he said he“did not believe that a lengthy, adversarial inquiry would be in the best interests of health care in Staffordshire.” Today it has emerged that in 2007, as a Junior Health Minister, he signed offon one of four stages of the Mid-Stafford Hospital’s elevation to Labour’s coveted Foundation Trust status. This was despite four formal alerts about the hospital’s dangerous practises. The rest they say is history. No wonder Dave was asking about this at PMQs yesterday. Guido just got off the phone with Julie Bailey of Cure the NHS, a local group campaigning for a full inquiry into the case, who said she had to go because “we’re just about to start filming” as Andrew Lansley was on the way. After Burnham’s “tired and emotional” outburst at Lansley last week for the death tax posters, Guido senses he may be dodging Nokias by the end of the tea time news…
Patients often face multiple moves around hospital
