Recommendation F48: Use of information about compliance by regulator from: Foundation trust governors and scrutiny committees
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Care Quality Commission should send a personal letter, via each registered body, to each foundation trust governor on appointment, inviting them to submit relevant information about any concerns to the Care Quality Commission.
In brief (written by this site)
The Department of Health and Social Care and NHS England stated in September 2024, in an update published in February 2026, that the Care Quality Commission involves governors in inspections and holds induction sessions with groups of them when they are appointed (DHSC and NHS England, Feb 2026). Previously, the Thirlwall Inquiry legal team noted in May 2024 that the recommendation had been accepted in principle, recording that the commission's methodology would invite relevant councils of governors to contribute evidence as part of an inspection (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 in principle.
Professor Sir Mike Richards, the Chief Inspector of Hospitals, has already written to Foundation Trust Councils of Governors about the first wave of his new NHS Trust inspections, setting out how Councils of Governors can be involved in listening events, can feed in information to the inspections, and can contact the local Care Quality Commission manager if at any time they wish to raise questions or provide further information to it in relation to the quality of care provided by the trust. The Foundation Trust Council of Governors was used to convey this information to individual Governors because of their requirement to work collectively as a Council.
The Care Quality Commission has worked with Monitor to ensure that Foundation Trust governors have clear guidance on the Care Quality Commission’s role and how to raise concerns. This information will be available to governors on an on-going basis, and to newly appointed governors, in addition to the one-off letter that has been sent.
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)
CQC involve governors in inspections and have induction sessions with groups of them when they’re appointed.
Please see our response to Recommendation 47 for NHS England guidance in relation to Foundation Trust governors.
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. 48, PDF page 450.
Department of Health and Social Care says in progress (11 February 2015)
The Care Quality Commission has extended the independent panel for governors run by Monitor so that it now also acts as an independent panel for Councils of Governors to raise queries they have in relation to healthcare standards.
The Care Quality Commission wrote to all Foundation Trust Councils of Governors in Autumn 2013 when it announced its new approach, informing them of the first wave of its new acute inspections. Following this, it was agreed that it would become part of the Care Quality Commission’s methodology to invite the relevant Council of Governors to contribute evidence as part of an inspection. Further work is being undertaken to embed this.
The Care Quality Commission is also undertaking work to ensure that there is an effective framework in place so that its hospital inspection teams know how Councils of Governors should be invited to contribute evidence. The Care Quality Commission will be publishing a briefing for all Foundation Trust Councils of Governors about its new approach and standards of care.
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 in principle by the Government.
In the January 2014 Hard Truths report, the Government referred to the Chief Inspector of Hospitals writing to Foundation Trust Councils of Governors about the new wave of inspections and how governors could be involved in listening events, feed in information to inspections and at any time contact the Care Quality Commission. It was also agreed that Care Quality Commission methodology would invite relevant Council of Governors to contribute evidence as part of an inspection.
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. 48, PDF page 413.
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