Recommendation F144: Need for ownership of quality metrics at a strategic level
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The NHS Commissioning Board should ensure the development of metrics on quality and outcomes of care for use by commissioners in managing the performance of providers, and retain oversight of these through its regional offices, if appropriate.
In brief (written by this site)
In September 2024 commentary published in February 2026, the Department of Health and Social Care and NHS England recorded implementation as ongoing, stating, "Please see response to recommendation 143" (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted earlier updates regarding the NHS Outcomes Framework and specialty reporting (The Thirlwall Inquiry legal team, May 2024). The department had previously reported in February 2015 that an outcomes indicator set for clinical commissioning groups was expanding annually and that consultant-level outcomes data was scheduled to be published before 2020 (Department of Health, Feb 2015).
Sources
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 NHS Outcomes Framework 2013–14 (Department of Health, November 2012) contains a range of indicators that provide a balanced coverage of NHS activity that, taken together, provide a national overview of how well the NHS is performing. They provide the accountability mechanism between the Secretary of State for Health and NHS England for the effective spending of public money. The indicators are set out in five domains that cover the preventing of premature mortality; enhancing quality of life for people with long term conditions; helping people recover from episodes of ill health; ensuring the people have a positive experience of care; and treating people in safe environments and protecting them from avoidable harm.
In addition to this, NHS England also publishes a range of data that supports improvement. In June 2013, NHS England published the first two specialities level data, cardiac surgery and vascular, and announced the publication schedule for a further eight specialties. All specialties have since been published.
NHS England will widen this programme to include other specialties over time and the data published will, initially, be refreshed annually. This data will continue to be published as part of NHS Choices website.
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)
Please see response to recommendation 143.
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. 144, PDF page 493.
Department of Health and Social Care says in progress (11 February 2015)
The Clinical Commissioning Group Outcomes Indicator Set provides clear, comparative information for Clinical Commissioning Groups, Health and Wellbeing Boards, local authorities and patients and the public about the quality of health services commissioned by Clinical Commissioning Groups and the associated health outcomes. They are useful for Clinical Commissioning Groups and Health and Wellbeing Boards in identifying local priorities for quality improvement and to demonstrate progress that local health systems are making on outcomes. The measures are developed from NHS Outcomes Framework indicators that can be measured at Clinical Commissioning Group level together with additional indicators developed by the National Institute for Health and Care Excellence and the Health and Social Care Information Centre. Additional measures are added annually
NHS England plans to publish consultant-level outcomes data from all appropriate NHS funded national clinical audits before 2020. The Consultant Outcomes Publication began with ten national clinical audits in June 2013. Consultant data for neurosurgery and upper gastro-intestinal has also now been published. NHS England will improve the way in which data is published and has supported the development of patient-friendly guidance which has been issued to professional societies. This outlines the indicators that must be included in consultant level reporting such as patient involvement in publication and the linking of results for the department to an individual’s work at the trusts they practice in.
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 England, 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 the NHS Outcomes Framework, contained in a range of indicators which provided national overview of how well the NHS was performing. The Government said that NHS England planned to widen a programme of publishing specialities level data on NHS Choices. In the February 2015 Culture Change report, the Government referred to the Clinical Commissioning Group Outcomes Indicator Set, which it said provided clear, comparative information for clinical commissioning groups, Health and Wellbeing Board, local authorities and patients and the public about the quality of health services. The Government said that NHS England planned to publish consultant-level outcomes data from all appropriate NHS-funded national clinical audits before 2020. .
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. 144, PDF page 459-460.
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