Coordination of local public scrutiny bodies
Guidance should be given to promote the coordination and cooperation between Local Healthwatch, Health and Wellbeing Boards, and local government scrutiny committees.
- The Health Overview and Scrutiny Committee principles, published in July 2022, established five best practice points for joint working between scrutiny committees, ICBs, and local system partners (Health Overview and Scrutiny Committee Principles, DHSC, July 2022).
- The government reported in November 2013 that it would promote coordination between Healthwatch, Health and Wellbeing Boards, and scrutiny committees through statutory guidance (Hard Truths: The Journey to Putting Patients First, DHSC, November 2013).
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe 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
Progress Timeline
DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Implemented - Closed. Guidance on local authority scrutiny was updated in January 2024. Under the health overview and scrutiny committee principles, there are 5 points of best practice for ways of working between health overview and scrutiny committees, ICBs, ICPs and other local system partners. The principles are that joint working should be outcome focused, balanced, inclusive, collaborative and evidence informed. To ensure the benefits of scrutiny are realised, these principles should form the basis of ongoing discussions between system partners about how they will work together.
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.
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.
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.
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.