A review into a hospital trust in Essex criticised for hygiene lapses and death rates has called for better leadership.
Basildon and Thurrock University Hospital NHS Foundation Trust came under fire after an inspection by the the Care Quality Commission (CQC).
The Nursing and Midwifery Council (NMC) has now published the findings of its extraordinary review into the Trust.
It found that standards for education of staff were being met but called for a stronger leadership.
Basildon and Thurrock University Hospitals NHS Foundation Trust has two hospitals serving about 300,000 people.
The CQC report revealed last year higher-than-expected death rates among patients, and poor standards of hygiene, including blood-spattered kit.
The latest findings by the Nursing and Midwifery Council highlighted "the need for stronger leadership, improved communication channels between senior staff and those on the wards, and a robust reporting system for staff to effectively raise concerns about problems in the environment of care that may put people at risk".
The review included 22 recommendations to address these and other issues, including monitoring the variance in the standard of care in the accident and emergency department.
It also recommended that the trust reviews the midwifery staffing shortfall.
The trust Chief Executive Alan Whittle said: "The NMC's review was carried out in December following concerns raised by the Care Quality Commission and Monitor.
"The issues and recommendations the NMC makes... are largely already being addressed through the current work we are undertaking, which Monitor is overseeing; any that are not already covered will be added, and we will respond in full to the NMC to reassure them.
"It was acknowledged at the end of November that it would take at least six months to address all of the regulatory concerns; we are only half way through that period but are making demonstrable progress."