Recommendation F76: Enhancement of role of governors
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Arrangements must be made to ensure that governors are accountable not just to the immediate membership but to the public at large – it is important that regular and constructive contact between governors and the public is maintained.
In brief (written by this site)
In commentary provided in September 2024, the Department of Health and Social Care and NHS England stated that an addendum published in 2022 explains how foundation trust councils of governors should interact regularly with members and the public (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation while determining that definitions of how governors engage the public should be agreed locally between boards and governors rather than set in law (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.
The Health and Social Care Act 2012 provides that one of the general duties of the Council of Governors is to represent the interests of the members of the corporation as a whole and the interest of the public. Governors are elected from the membership of the Foundation Trust, who in turn consist of staff members, the general public and sometimes, patients or service users and their carers.
How governors engage and represent the public is not defined in law, as Foundation Trust boards and governors will agree between themselves how governors should work day-to- day. Examples of methods by which governors may represent the interests of the public are included in Chapter 4 of Monitor’s publication Your statutory duties: a reference guide for NHS Foundation Trust governors (Aug 2013).
Monitor, Department of Health, 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.
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)
Monitor has merged with NHS England.
In 2013 Monitor published guidance for Foundation Trust governors. In 2022 NHS England published an addendum governors’ to statutory duties to reflect the different landscape of the NHS.
Under the National Service Act 2006, councils of governors have a duty to represent the interests of the members of the NHS foundation trust and the public. The addendum explains how the council of governors should therefore interact regularly with the members of the trust and the public to ensure it understands their views, and to clearly communicate information on trust and system performance and planning in return.
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. 76, PDF page 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
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 by the Government.
In the January 2014 Hard Truths report, the Government said that one of the Council of Governors under the Health and Social Care Act 2012 was to represent the interest of members of the corporation as a whole and the interest of the public. However, the Government said that no definition of how governors engage and represent the public would be provided in law, it considering such arrangements being a matter for agreement between foundation trust boards and governors. However, the Government said that examples of methods by which governors might represent the interests of the public were included in Monitor’s August 2013 guidance.
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. 76, 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