F145 Response Not Accepted

Structure of Local Healthwatch

Recommendation

There should be a consistent basic structure for Local Healthwatch throughout the country, in accordance with the principles set out in Chapter 6: Patient and public local involvement and scrutiny.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
- The Health and Social Care Act 2012 (sections 221-227) established the statutory framework for Local Healthwatch organisations. Every upper-tier local authority in England is required to commission a Local Healthwatch for its area. 152 Local Healthwatch organisations were established from April 2013, covering every local authority area in England (Health and Social Care Act 2012, Part 5, Chapter 1).
- Local Healthwatch organisations have a consistent set of statutory functions set out in the Health and Social Care Act 2012: obtaining the views of people about their needs and experiences of local health and social care services; making reports and recommendations about how services could be improved; providing information and advice to the public; making the views and experiences of people known to Healthwatch England; and making recommendations to those who commission, provide, and regulate health and social care services (Health and Social Care Act 2012, s.221).
- Healthwatch England, initially established as a statutory committee of CQC under the Health and Social Care Act 2012, provides national coordination and support to the Local Healthwatch network. Healthwatch England publishes guidance, quality standards, and best practice resources for Local Healthwatch organisations, promoting consistency across the network (Healthwatch England).
- The Local Healthwatch Regulations 2013 (SI 2013/154) set out further requirements for the governance and operation of Local Healthwatch organisations, including requirements for annual reporting and the involvement of volunteers and lay people in Healthwatch activities (SI 2013/154).
How was this evidence gathered?
Evidence searched by Claude (Anthropic) on 10 Apr 2026
Checked data held on this site (government responses, progress updates, independent evidence)
This recommendation applies across many organisations. The evidence above reflects central policy activity; adoption in individual organisations may vary.
Jurisdiction
England
Response
Not Accepted
Not Accepted Department of Health and Social Care
19 Nov 2013

The government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf

Read Full Response
Note: 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.
Published Evidence

Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.

Reasonable Progress
06 Feb 2023
Academic Review - Ten Years After Francis

Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.

University of Birmingham: Ten years after Francis View Source
Good Progress
11 Feb 2015
UK Government - Culture Change in the NHS

Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.

Good Progress
19 Nov 2013
UK Government - Hard Truths Vol 1 & 2

Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.

Source
Report Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry 06 Feb 2013
Responsible Bodies
Department of Health and Social Care Primary
Recommendation age 13.3 yrs
Last formal update 4577 days ago