High quality care must be centre stage in the NHS and take priority over hitting targets, a report put together by key managers in health service trusts said.
The research found enthusiasm for the proposals put forward by the Francis report, but warned of a "profound tension" between the quality of car desired and what could be paid for.
However, the report noted that one leader said: "I'd rather be hung for money than for quality and safety."
The report said Francis had "brought a powerful sense of professional shame" but added:
The pressure to stay within limited budgets that existed at the time of Mid Staffordshire has not gone away but has intensified, as funding increases for the NHS have been frozen in real terms since 2011/12.
More top news
Could the Internet hold the key to easing the burden on our overstretched health service? Dr Oscar Duke reports for Tonight.
An agreement that Syria's Idlib province should be a safe haven is being ignored by its own government, writes John Irvine.
Clear, crisp & freezing cold with fresh falls of snow