Recommendation F75: Enhancement of role of governors
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Council of Governors and the board of each foundation trust should together consider how best to enhance the ability of the council to assist in maintaining compliance with its obligations and to represent the public interest. They should produce an agreed published description of the role of the governors and how it is planned that they perform it. Monitor and the Care Quality Commission should review these descriptions and promote what they regard as best practice.
In brief (written by this site)
In February 2026, the Department of Health and Social Care and NHS England reported that the recommendation was partially implemented and closed, stating that the government did not seek to prescribe how governors should work day to day and that regulators would not agree descriptions agreed between boards and governors (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team found that the recommendation had been accepted in part by the government, noting that Monitor and the Care Quality Commission would not review descriptions agreed between them (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 in part.
In August 2013 Monitor published a revised version of Your statutory duties: a guide for NHS Foundation Trust Governors which includes guidance on the new statutory duties from the Health and Social Care Act 2012. This guidance has been published in association with the Department of Health, Care Quality Commission, Foundation Trust Network and Foundation Trust Governors Association.
The above organisations recognise the variety of non-statutory duties that governors may perform, as well as the importance of preserving the autonomy of individual trusts and therefore the guidance does not seek to prescribe how governors should work day-to-day; NHS Foundation Trust boards and governors will agree this between themselves. Monitor and the Care Quality Commission will not review the descriptions produced by each Foundation Trust agreed between boards and governors.
Monitor, the Department, Care Quality Commission, Foundation Trust Network and Foundation Trust Governors Association are planning a series of good practice guides to support governors in carrying out their duties. The first of these guides is planned to be on representing the interests of members and the public. In addition, Monitor, the Foundation Trust Network and the NHS Leadership Academy have commissioned the GovernWell programme, a new national training programme for Foundation Trust governors designed to help equip governors and non-executives with the skills they need to perform effectively.
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 partially delivered (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. Please see our response to recommendation 47 and 74 for NHS England guidance and available support in relation to Foundation Trust governors. As set out in Government response, the Government stated that they did not seek to prescribe how governors should work day to day, and the CQC and Monitor would not agree the descriptions agreed between them.
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 “Partially implemented – Closed”. Table row: section 18.2 No. 75, PDF page 461-462.
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.
The GovernWell national training programme for foundation trust governors was launched in May 2013. GovernWell is a four tier programme that offers pre-induction resources, an induction toolkit, and core and specialist skills modules. Each tier of the programme builds on the last, offering governors the opportunity to build their knowledge and skill base to effectively operate in the role.
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 NHS trusts, 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 part by the Government.
In the January 2014 Hard Truths report, the Government referred to the various guidance as described in relation to recommendation 74 above. However, the Government said that this did not seek to prescribe how governors should work day-to-day, which was for NHS Foundation Trust boards and governors to agree. Monitor and the Care Quality Commission would not review the descriptions agreed between them.
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. 75, PDF page 427.
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