Recommendation F32: Interim measures
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Where patient safety is believed on reasonable grounds to be at risk, Monitor and any other regulator should be obliged to take whatever action within their powers is necessary to protect patient safety. Such action should include, where necessary, temporary measures to ensure such protection while any investigation required to make a final determination is undertaken.
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in February 2026, the Department of Health and Social Care and NHS England reported that the recommendation was superseded, noting that the Care Quality Commission can use civil and enforcement powers to suspend or cancel registrations alongside the NHS Patient Safety Incident Response Framework (DHSC and NHS England, Feb 2026). Previously, in May 2024, the Thirlwall Inquiry legal team observed that the government had accepted the recommendation, noting earlier reports on regulatory intervention powers under the special measures regime (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.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted.
As part of the overall single failure regime (see recommendation 19) it is important that where the Care Quality Commission, Monitor or the NHS Trust Development Authority identify breaches of fundamental standards that they can act swiftly to resolve those issues.
As such, the Care Quality Commission has retained both its ability to impose enforcement action to ensure that patient safety risks are addressed and to stop the provision of a service where it is putting people at immediate risk of harm as outlined by the Health and Social Care Act 2008.
Subject to the passage of appropriate regulations, the Care Quality Commission will also be able to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first. See recommendations 28 and 30 for further details.
Monitor and the NHS Trust Development Authority have retained their powers to intervene at their discretion if urgent action is required. Details of this are outlined as part of the response to recommendation 31.
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 state no delivery position (27 February 2026)
Please see our response to recommendation 31.
The CQC can take enforcement action against anyone who provides regulated activities without registration, and against registered persons who breach conditions of their registration or relevant sections of the Health and Social Care Act 2008, the Care Quality Commission (Registration) Regulations 2009, The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, or other legislation that is relevant to achieving registration.
Where breaches of regulation do not constitute a criminal offence, the CQC can enforce the standard by using civil powers to impose, vary or remove conditions, suspend registration or cancel registration.
In addition, the Patient Safety Incident Response Framework (PSIRF) sets out the NHS’s approach to developing and maintaining effective systems and processes for responding to patient safety incidents for the purpose of learning and improving patient safety.
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 “Superseded”. Table row: section 18.2 No. 32, PDF page 440.
Department of Health and Social Care says in progress (11 February 2015)
Under the new special measures regime, the NHS Trust Development Authority and Monitor are now able to intervene at providers which the Care Quality Commission judge to be providing poor quality care as part of their new inspection programme. This includes partnering the failing provider with a high-performing buddy, the appointment of a dedicated Improvement Director at the trust as well as other targeted interventions to ensure rapid improvements where failings have been identified.
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 Monitor, 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 referred to the Care Quality Commission retaining its ability to impose enforcement action as well as stop the provision of a service where it is putting people at immediate risk of harm; as well as Monitor and the NHS Trust Development Authority retaining their powers to intervene at their discretion if urgent action is required.
In the February 2015 Culture Change report, the Government also referred to the new special measures regime, which it said allowed the NHS Trust Development Authority and Monitor to intervene at providers which the Care Quality Commission judged to be providing poor quality care.
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. 32, PDF page 402.
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