Recommendation F52: Enhancement of monitoring and the importance of inspection
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Care Quality Commission should consider whether inspections could be conducted in collaboration with other agencies, or whether they can take advantage of any peer review arrangements available.
In brief (written by this site)
In September 2024 commentary published in February 2026, the Department of Health and Social Care and NHS England reported that the Care Quality Commission conducts joint local authority area inspections with partner inspectorates including Ofsted, involves the health service body in trust-level well-led assessments, and notes external review principles produced by the Academy of Royal Medical Colleges (DHSC and NHS England, Feb 2026). Previously, the Thirlwall Inquiry legal team observed in May 2024 that while the commission had entered joint working protocols with the Nursing and Midwifery Council and the General Medical Council, only the nursing protocol explicitly referenced aligned visits and inspection activity (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.
The Care Quality Commission is developing Memoranda of Understanding with medical, nursing and midwifery Royal Colleges. These will ensure that peer review and accreditation schemes are taken fully into account as new methods of inspection are introduced in each sector and evolve. The Care Quality Commission will continue joint inspection with other regulators and inspectorates. This will include extending from December 2013 the approach to coordination developed with the General Medical Council (see below), to other professional regulators.
In A new start – Consultation on changes to the way Care Quality Commission regulates, inspects and monitors care the Care Quality Commission consulted on new approaches to regulation and, as part of that, proposed closer work with other agencies and better use of accreditation and peer review schemes. On 17 October 2013, it published the responses to the consultation in A new start: Responses to our consultation on changes to the way Care Quality Commission regulates, inspects and monitors care services, which showed that there is broad agreement with the new approach.
The Care Quality Commission and the General Medical Council have explored coordination through shadowing each other’s inspections and assessments of professional education; this is reflected in an operational protocol50 that they have published. Discussions are under way on how best to learn from this, and extend the learning to other professional regulators in healthcare.
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 have some joint inspections. For example, inspections of local authority areas in partnership with Ofsted, HM Inspectorate of Constabulary, HM Inspectorate of Probation and, where relevant, HM Inspectorate of Prisons. The CQC also involve NHS England at trust level well led assessments. Please see our response to recommendation 35 for how NHS England works with CQC. The Academy of Royal Medical Colleges produced key principles for the undertaking of external reviews.
Principles 13, 14, 15 and 16 are relevant to good governance.
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. 52, PDF page 452.
Department of Health and Social Care says in progress (11 February 2015)
Under the leadership of the Chief Inspectors, the Care Quality Commission has put in place specialist inspection teams that subject providers to greater scrutiny. Inspections now routinely involve expert inspectors and people with experience of receiving.
The Care Quality Commission is currently undertaking work whether on it might take account of accreditation schemes in Adult Social Care. During May 2014, the Care Quality Commission held a series of roundtable events with stakeholders and also co-production sessions, which generated mixed views. As a consequence, the Care Quality Commission with its staff and stakeholders will be giving further consideration to accreditation.
Memoranda of Understanding are being developed and revised with other strategic partner organisations, often supported by joint operating protocols. For example, a joint working protocol has recently been established with the Nursing and Midwifery Council and will be embedded in 2015. The Care Quality Commission is close to updating its joint working arrangements with the National Institute for Health and Care Excellence and the Health and Care Professionals Council, and the Care Quality Commission intelligence teams are liaising with the Health and Care Professionals Council on routine information sharing.
General Medical Council /The Care Quality Commission protocol
• The General Medical Council and the Care Quality Commission reviewed their Joint Operating Protocol, and published the revised version on 11 December 2014.
Revalidation and General Medical Council/The Care Quality Commission joint training
• The Care Quality Commission has submitted their Annual Organisational Audit report
• The Care Quality Commission is preparing a development plan to set up structure and processes for the Care Quality Commission as a designated body.
• The Care Quality Commission is including questions about appraisal and revalidation in our GP inspections.
• The Care Quality Commission is developing a process for working with Area Teams to discuss practice and individual performance prior to and following inspections.
• A representative from the Care Quality Commission sits on the General Medical Council’s Expert Advisory Group on Standards for Education and Training. The Care Quality Commission has introduced the concept of Key Lines of Enquiry to this group and this methodology is now being looked at in the creation of new standards.
• An e-learning package is being developed – by agreement with the Chief Inspector for Primary Medical Services and Integrated Care, Professor Steve Field - and will be integrated into the Care Quality Commission’s annual programme of GP training. Data to support GP inspections:
• Internal discussions at the Care Quality Commission are underway to understand how the General Medical Council can provide information to support this process. Data to support hospital inspections: The General Medical Council continues to send the Care Quality Commission sets of information relating to individual trusts, for use as part of our inspection process. The data covers each of their core functions: Registration & Revalidation, Fitness to Practise and Education. The General Medical Council also shares this information with the responsible officer at the trust. Information Sharing Agreement: Development of the Information Sharing Agreement and the individual sharing schedules therein has been progressing slowly, partly due to the development of the Care Quality Commission’s new approach and data packs, but it is a priority and the Care Quality Commission is aiming to finalise this in the near future.
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.
The Care Quality Commission entered into joint working protocols with the Nursing and Midwifery Council (in 2015) and the General Medical Council (revised in December 2014).
As to current versions, the Care Quality Commission – Nursing Midwifery Council joint working protocol makes explicit reference to involvement of the Nursing and Midwifery Council in the inspection regime, including information sharing and aligning of inspection and visiting activities. The Care Quality Commission – General Medical Council joint working protocol makes mention of exchange of information, but does not explicitly refer to inspections. The Government also said in the February 2015 Culture Change report that the General Medical Council continued to send the Care Quality Commission information relating to individual trusts for use as part of the inspection process, which related to registration and revalidation, fitness to practise and education.
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. 52, PDF page 415-416.
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