Expert assistance
Scrutiny committees should be provided with appropriate support to enable them to carry out their scrutiny role, including easily accessible guidance and benchmarks.
- The Department of Health and Social Care published statutory guidance on health scrutiny in June 2014 ("Local authority health scrutiny: guidance to support local authorities and their partners to deliver effective health scrutiny"), setting out best practice for the conduct of health scrutiny and the relationship between scrutiny committees and NHS bodies (DHSC health scrutiny guidance, June 2014).
- The Centre for Governance and Scrutiny (CfGS) has published guidance and resources for health scrutiny committees, including benchmarking tools and practical advice on questioning techniques, evidence gathering, and report writing. CfGS provides a training and development programme for scrutiny members and officers (CfGS health scrutiny resources).
- The Local Government Association (LGA) has published guidance on health scrutiny, including a councillor handbook on health scrutiny. However, Local Healthwatch England's evidence to parliamentary committees and Healthwatch England's annual reports have noted that the level of support available to health scrutiny committees varies significantly between local authorities, and that many scrutiny committees lack dedicated officer support and access to independent expert advice (LGA health scrutiny resources).
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
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.