Recommendation F30: Interim measures
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The healthcare regulator must be free to require or recommend immediate protective steps where there is reasonable cause to suspect a breach of fundamental standards, even if it has yet to reach a concluded view or acquire all the evidence. The test should be whether it has reasonable grounds in the public interest to make the interim requirement or recommendation.
In brief (written by this site)
In commentary from September 2024 published in February 2026, the Department of Health and Social Care and NHS England recorded the recommendation as implemented and ongoing, pointing to the Care Quality Commission's enforcement policy (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation, observing that the regulator retained statutory powers to halt unsafe care alongside warning notices introduced under the Care Act 2014 (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.
As part of the overall single failure regime (see recommendation 19) it is important that where the Care Quality Commission identify breaches of fundamental standards that it is able to act quickly. As such the Care Quality Commission will retain its ability to stop a service from providing care if it is putting people at immediate risk of harm as outlined by the Health and Social Care Act 2008. The Act states that where the Care Quality Commission has ‘reasonable cause’ to believe that unless it acts people may be exposed to the risk of harm, it may impose, or vary a condition of a provider’s registration or suspend it from the point written notice is given as part of an urgent response.
In addition, subject to the passage of regulations, during 2014 the Care Quality Commission will also have new powers to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first. See recommendation 28 for further details.
The powers outlined above are supported by the Care Quality Commission’s new regulatory model, and its new approach to inspections. This approach is outlined in more detail in recommendations 50 and 51.
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)
The Thirlwall Inquiry has noted action taken following the conclusion of the Mid-Staffordshire Inquiry 2013. See CQC's enforcement policy
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. 30, PDF page 439.
Department of Health and Social Care says in progress (11 February 2015)
The Care Act 2014 has created an additional form of warning notice specifically for NHS Trusts and Foundation Trusts. The Care Quality Commission can now issue these where it judges that a trust requires significant improvement (not necessarily tied to breaches of regulations). This warning notice can lead to the provider entering the failure regime. Also, subject to the passage of regulations during 2014, the Care Quality Commission will have new powers to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first.. The intention is that regulations will be in place in April 2015.
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.
Site note: The Inquiry addressed this recommendation to the Care Quality Commission, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on 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 would retain its ability to stop a service from providing care if it had reasonable cause to believe that unless it acts people may be exposed to the risk of harm. In the February 2015 Culture Change report, the Government also referred to the Care Act 2014, which created an additional form of warning notice for NHS trusts and foundations trusts.
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. 30, PDF page 401.
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