36 Response Accepted AI-assessed

Impact assessment of policy changes

Recommendation

The cumulative impact of new policies and processes, particularly the perceived pressure to achieve Foundation Trust status, together with organisational reconfiguration, placed significant pressure on the management capacity of the University Hospitals of Morecambe Bay NHS Foundation Trust to deliver against changing requirements whilst maintaining day-to-day needs, including safeguarding patient safety. Whilst we do not absolve Trusts from responsibility for prioritising limited capability safely and effectively, we recommend that the Department of Health should review how it carries out impact assessments of new policies to identify the risks as well as the resources and time required. Action: the Department of Health.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
According to government responses from March and July 2015, the Department of Health strengthened its impact assessment processes for major policy changes to better consider their cumulative impact on NHS trusts. Additionally, the Foundation Trust application process was significantly improved, requiring a strong focus on quality of care and governance to prevent distortion of management capacity and priorities. According to the available evidence, no further published evidence on the ongoing effectiveness of these strengthened processes has been identified since the 2015 government responses.
How was this assessed?
Assessed by gemini-2.5-flash on 19 Mar 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.legislation.gov.uk, hansard.parliament.uk
Jurisdiction
England
Response
Accepted
Accepted Department of Health and Social Care
16 Jul 2015

97. We accept this recommendation in principle.
We acknowledge the
Investigation’s findings that the pursuit of Foundation Trust status distorted
management capacity and priorities at Morecambe Bay.
98. In response to the failings at both Mid Staffordshire NHS Foundation Trust and
University Hospitals of Morecambe Bay NHS Foundation Trust:
• the Foundation Trust application process has now been significantly
improved, requiring a strong focus on quality of care as well as on governance
and good financial control.
• The Care Quality Commission now works closely with Monitor and the NHS
Trust Development Authority to share intelligence about the Trusts’
performance capacity and capability.
• Under the Care Quality Commission’s new ratings system, NHS Trusts need
an overall rating of “good” or “outstanding” to progress to the next stage of the
Foundation Trust assessment process
• The Care Quality Commission’s new inspection model, including the
development of its intelligent monitoring tool, ensures that issues of concern
are picked up earlier and can be addressed.
99. The Department of Health will continue work with its Arms’ Length Bodies to
develop policy in partnership, and ensure that oversight and regulatory mechanisms
are as effective as possible in ensuring sustainable high quality care. Formal impact
assessments are and will continue to be an important part of how new policies are
considered and implemented.

Read Full Response
Source
Inquiry Morecambe Bay Investigation
Report Report of the Morecambe Bay Investigation 03 Mar 2015
View Source
Responsible Bodies
Department of Health and Social Care Primary
Themes & Tags
DWP policy impact assessment Major Project Scope Uncertainty Impact Assessment Policy Capacity
Recommendation age 11.1 yrs
Last formal update 3904 days ago