Recommendation F46: Use of information about compliance by regulator from: Quality and risk profiles
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Quality and Risk Profile should not be regarded as a potential substitute for active regulatory oversight by inspectors. It is important that this is explained carefully and clearly as and when the public are given access to the information.
In brief (written by this site)
In February 2026, the Department of Health and Social Care and NHS England reported that the recommendation had been superseded because the Care Quality Commission had transitioned to a Single Assessment Framework, while noting that an interim review had highlighted areas needing operational improvement (DHSC and NHS England, Feb 2026). Previously, in May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation and replaced the quality and risk profile approach with sector-wide risk indicator analyses and revised inspection procedures (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.
Replacing the quality and risk profile approach, since October 2013 the Care Quality Commission has published its analysis of risk indicators for the entire hospital sector, showing how all hospital providers perform against these indicators of risk. Updates will be published quarterly. Under its new inspection approach, spearheaded by the Chief Inspector of Hospitals, as it carries out each inspection under its new approach, the Care Quality Commission will publish the data pack at the same time as publishing the inspection report. A data pack is a detailed analysis of key information that the Care Quality Commission holds about a provider, including its performance on risk indicators, other sources of data, and qualitative information such as views of local organisations and feedback from patients.
The Care Quality Commission’s new approach is designed to support inspection by specialist teams, through inspections based on identifying lines of enquiry from whatever quantitative and qualitative information suggest about standards of care, rather than focused on regulations. Under the new approach the Care Quality Commission also analyses information about providers to decide the timing of inspections so that there is timely follow-up to potential concerns. This is to clarify the difference between on-going monitoring, and judgements by inspectors at certain points within that.
The Care Quality Commission has begun its new approach to monitoring providers in the hospital sector. New Chief Inspectors of General Practice and of Adult Social Care took up post in October 2013 and will now spearhead the extension and development of new approaches to monitoring standards of care in those sectors. The Deputy Chief Inspector of Mental Health will report to the Chief Inspector of Hospitals on how this applies to mental health services.
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)
Since this recommendation, CQC have changed their assessment framework to a Single Assessment Framework.
In addition, please see our response to Recommendation 31 above for information on the role of the Joint Strategic Oversight Group, National Quality Boards and System Quality Groups in quality surveillance.
The interim Penny Dash Review findings highlighted clear areas where improvement is urgently needed for CQC to be an effective regulator. Interim recommendations included a review of CQC’s operational effectiveness linked to how CQC delivers its strategic objectives and regulatory responsibilities. Please see response to recommendation 55 for further information on this review.
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. 46, PDF page 449.
Department of Health and Social Care says in progress (11 February 2015)
In March and July 2014, the Care Quality Commission updated its surveillance model for acute NHS trusts and in July 2014, it published for the first time surveillance models for adult social care, general practice, community and mental health providers.
In January 2014, the Care Quality Commission started its new inspection programme for mental health trusts, community trusts and general practice out of hours services. In April 2014, new style inspections started in adult social care. The first new inspections for ambulance services and dentists started in July 2014.
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 quality and risk profile approach had been replaced since October 2013, with the Care Quality Commission publishing its analysis of risk indicators for the entire hospital sector, showing how providers performed against the indicators.
The Government referred to the Care Quality Commission’s new inspection regime, with inspections based on identifying lines of enquiry from whatever quantitative and qualitative information suggestion about standards of care, rather than being focused on regulations.
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. 46, PDF page 412.
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