Responsibility for regulating and monitoring compliance
It should be considered the duty of all specialty professional bodies, ideally together with the National Institute for Health and Clinical Excellence, to develop measures of outcome in relation to their work and to assist in the development of measures of standards compliance.
- The NCIP portal provides specialty-specific dashboards at the patient level for 14 surgical specialties as of April 2025 (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- The government reported in 2013 that it accepted the duty of professional bodies to develop outcome measures in relation to their work (Hard Truths: The Journey to Putting Patients First, DHSC, November 2013).
- No further independent evidence regarding the public publication of these outcome measures has been identified since 2025.
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf
Progress Timeline
DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Partially Implemented - Ongoing. See response to Recommendation 23 about the National Consultant Information Programme (NCIP). The NCIP portal is a free data platform that allows consultants to review their own data: improving clinical quality, patient safety and supporting career development. It provides consultants with data covering their NHS practice wherever it is performed with high-quality, specialty-specific dashboards at patient level. Nearly all NHS Trusts and NHS Foundation Trusts in England have been enrolled in NCIP (99%) and over 9,000 consultants now have access to the portal following universal access given across 7 surgical specialties. NCIP is on track to give access to every consultant in 14 surgical specialties by 1 April 2025 with the intention of expanding into non-surgical specialties subsequently. Access to the portal has also been given to Medical Directors, Responsible Officers (who have governance responsibilities) and Trust Specialty Clinical Leads. NCIP is now established as the visualisation platform for individual consultant outcome data but for very cogent reasons is not in the public domain. However, once a single repository is established and there is confidence in the accuracy of the data, discussions will take place with the profession as to what information is appropriate for publication. Independent sector The NCIP portal contains outcome data on NHS procedures no matter where they are performed i.e. both in NHS Trusts, NHS Foundation Trusts and the Independent Sector (IS) but excludes those procedures performed on private patients carried out in the Independent Sector. It was always intended that these data would come into NCIP via the Acute Data Alignment Programme (ADAPt), as supplied by the Private Healthcare Information Network. ADAPt has now been subsumed into the Outcome and Registry Programme (ORP). A single repository can only be established when the private data flows into NCIP Please also see response to recommendation 23 (Clinical outcomes).
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.
Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.
Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.