Recommendation F74: Enhancement of role of governors
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Monitor and the Care Quality Commission should publish guidance for governors suggesting principles they expect them to follow in recognising their obligation to account to the public, and in particular in arranging for communication with the public served by the foundation trust and to be informed of the public's views about the services offered.
In brief (written by this site)
DHSC and NHS England stated in commentary of September 2024, published in February 2026, that the recommendation was implemented and closed, noting that Monitor had merged with NHS England and an updated reference guide for governors was produced in 2022 (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the recommendation had been accepted, citing guidance previously published by Monitor and GovernWell on representing the interests of the public and foundation trust members (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.
Monitor published a number of guidance documents for Foundation Trust governors, most recently (August 2013) a revised version of Your statutory duties: a guide for NHS Foundation Trust Governors. This includes guidance on the new statutory duties from the Health and Social Care Act 2012, including that of representing the interests of members and of the public. This guidance has been published in association with the Department of Health, Care Quality Commission, Foundation Trust Network and Foundation Trust Governors Association.
Working in partnership with Monitor and the Foundation Trust Network, the NHS Leadership Academy has commissioned the GovernWell Programme, a new national training programme for Foundation Trust governors. The GovernWell programme is designed to help equip governors and non-executives with the skills they need to perform effectively, including improving their ability to challenge quality problems.
Monitor has also set up the Panel for Advising Governors, which has a former Foundation Trust chair as its Chair, together with 16 other experienced Members. The Panel has been operational since May 2013 and is ready to take questions from governors on topics as per the Health and Social Care Act 2012.
Monitor, the Department of Health, Care Quality Commission, Foundation Trust Network and Foundation Trust Governors Association have agreed to publish jointly a summary guide for all Councils of Governors on the respective roles of the sponsoring organisations, how they work together and how they work with Governors, by the end of December 2013.
Following this, the group is planning a series of good practice guides on key aspects of the governor role. The first of these guides is planned to be on representing the interests of members and the public, and is intended also to guide Foundation Trusts on how they will need to support governors in this aspect of their role.
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 completed (27 February 2026)
Monitor has now merged with NHS England.
Please see our response to recommendation 35 for an update on the latest regulatory landscape.
In 2013 Monitor produced a reference guide for NHS Foundation Trust Governors.
In 2014 Monitor produced a brief guide for Foundation Trust Governors.
In 2022 NHS England produced an update to the reference guide for governors to explain the changes in landscape since the original governance was published.
NHS Providers offers a governor support programme called GovernWell. This offers a range of resources, including guides on topics, newsletters and an induction toolkit.
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 – Closed”. Table row: section 18.2 No. 74, PDF page 461.
Department of Health and Social Care says in progress (11 February 2015)
In March 2014 Monitor published ‘Your duties: a brief guide for NHS foundation trust governors’ which sets out the role of Monitor and Care Quality Commission and also reminds governors of their legal responsibility to represent the interests of the public and members of the Foundation Trust. Work is also in hand to produce material to assist governors in representing the interests of the public. This guide is being produced with Monitor and NHS Providers and will be published shortly
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 said that Monitor had published a number of guidance documents for foundation trust governors, including a revised version of its guidance on statutory duties for foundation trust governors in August 2013. This included key principles to inform how governors should represent the interests of the public, including how to communicate with them.
Monitor and GovernWell also produced guidance for governors on representing the interests of members and the public and the Government referred to guidance published by Monitor in March 2014, providing a brief guide for governors.
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. 74, PDF page 426.
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