Recommendation F18: Responsibility for setting standards
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
It is essential that professional bodies in which doctors and nurses have confidence are fully involved in the formulation of standards and in the means of measuring compliance.
In brief (written by this site)
In commentary provided in September 2024 and published in February 2026, the Department of Health and Social Care and NHS England stated that professional regulators regularly consult their registrants and other stakeholders when formulating standards, coordinate through the Joint Strategic Oversight Group, and align quality across health and care via the National Quality Board (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation and summarised previous updates on the Care Quality Commission involving healthcare professionals in inspections and joint agreements (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
Government response
Accepted.
The Care Quality Commission is taking steps to ensure that stakeholders, particularly including professional bodies, are fully involved in designing and developing its new approach to inspection. The Care Quality Commission’s new approach to inspecting hospitals involves large teams of specialists as well as patient experts. The Care Quality Commission is working with medical and nursing Royal Colleges to resource the inspection teams. These teams give professionals a key role in how a hospital’s quality of care is assessed.
The Care Quality Commission has consulted extensively on its new approach to inspection. The consultation engaged 5,154 individuals and 4,500 organisations, plus 41 consultation events. Professional bodies, and individual professionals, have been prominent contributors to these. On 17 October 2013, the Care Quality Commission published the responses to the consultation in A new start: Responses to our consultation on changes to the way the Care Quality Commission regulates, inspects and monitors care services, which showed that there is broad agreement with the new approach.
The Care Quality Commission is undertaking further work to deepen the engagement of professional bodies in developing its new approach, and in particular medical, nursing and midwifery Royal Colleges. Memoranda of understanding are in development with all of these bodies, covering collaboration in:
• resourcing inspection teams;
• developing standards and expectations of ‘what good looks like’ in different services; and
• recognising accreditation schemes where that can encourage achievement of best practice standards and avoid duplicated inspection.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
In developing their standards, professional regulators will regularly consult with a range of stakeholders, including their registrant population, to ensure policies and guidance meet the needs of the professionals they regulate.
Professional regulators are members of the Joint Strategic Oversight Group (JSOG), which was established to support the joint working of regulators and oversight organisations including the General Medical Council, Nursing and Midwifery Council, Health Education England and Care Quality Commission.
JSOG is the forum for sharing intelligence, enhancing the sharing of information and coordinating regulatory action in response to safety concerns.
The National Quality Board (NQB) continues to champion the importance of quality and drive system alignment of quality across health and care on behalf of NHS England, the Care Quality Commission, the UK Health Security Agency, the National Institute for Health and Care Excellence, the Office for Health Improvement and Disparities, the Department of Health and Social Care, Healthwatch England and the Health Services Safety Improvement Body.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 18.2 No. 18, PDF page 432.
Department of Health and Social Care says in progress (11 February 2015)
All of the Care Quality Commission’s new style inspections involve healthcare professionals as part of the inspection teams, according to their areas of specialism and training and depending on the service being inspected. In addition to this many of the Care Quality Commission’s inspectors themselves come from specialist health backgrounds and are working in the sector in which they trained. For example, the Care Quality Commission inspectors who are clinical scientists and radiographers by training inspect radiology facilities and departments, both as individual inspections and as part of broader hospital inspections, providing specialist insight. The Care Quality Commission’s Chief Inspectors of Hospitals, Adult Social Care and General Practice themselves have significant experience and expertise in their sectors, as well as a number of their Deputy Chief Inspectors.
The Care Quality Commission has been working with healthcare professionals including the Royal Colleges and their faculties, as well as providers, the public and other stakeholders throughout the development of its new regulatory approach. This has included:
• Engagement in the development of the Care Quality Commission’s new approach to monitoring, inspecting and rating services and guidance on new regulations and enforcement powers
• Identification of healthcare professionals to participate in the Care Quality Commission’s inspections
• Support for the Care Quality Commission’s work on the use of clinical service accreditation schemes
• Commitment to working together through the development of memoranda of understanding, joint working statements and information sharing agreements
Joint agreements
The Care Quality Commission works with strategic partner organisations including healthcare professional bodies in the development and delivery of its regulatory activity. These partnerships are underpinned by the development of joint agreements which set out:
• clear expectations and objectives for the relationships
• a framework for information exchange and operational working
• clear evaluation criteria
• a public signal of intent to work together
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
In the January 2014 Hard Truths report, the Government said that the Care Quality Commission had worked with healthcare professionals, including the Royal Colleges and their faculties, providers, the public and other stakeholders in developing its new regulatory approach. In the February 2015 Culture Change report, the Government also referred to the Care Quality Commission’s new inspections involving healthcare professionals as part of the inspection teams as well as joint agreements between the Care Quality Commission and strategic partner organisations.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 18, PDF page 393-394.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding