Recommendation F150: Inspection powers
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Scrutiny committees should have powers to inspect providers, rather than relying on local patient involvement structures to carry out this role, or should actively work with those structures to trigger and follow up inspections where appropriate, rather than receiving reports without comment or suggestions for action.
In brief (written by this site)
The Inquiry recommended giving scrutiny committees powers to inspect healthcare providers or trigger inspections. In commentary of September 2024, published in February 2026, the Department of Health and Social Care (DHSC) and NHS England stated that health overview and scrutiny committee principles published in July 2022 set expectations for information sharing and evidence requests, without mentioning inspection powers (DHSC and NHS England, Feb 2026). The Thirlwall Inquiry legal team noted in February 2026 that the government accepted the recommendation in principle, having concluded that granting local authorities additional inspection powers would be duplicative and burdensome (The Thirlwall Inquiry legal team, Feb 2026).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 5 Oct 2026. The record below is the sources' own words.
Government response
Accepted in principle.
Under current provisions, bodies carrying out local authority scrutiny functions have legal powers to require providers of NHS services to provide information and to attend scrutiny meetings to answer questions. This could include making a request to visit providers’ premises. Where a body carrying out local authority scrutiny function had concerns about a specific provider, they could refer the matter to the Care Quality Commission, who have powers of inspection.
Meanwhile, local Healthwatch has the power to enter and view certain premises, as well as powers to provide information and refer concerns to local authority scrutiny bodies.
Giving further powers to local authorities would therefore be duplicative and potentially burdensome. It might also create confusion over roles and responsibilities.
The work of Local Authority health scrutiny is already integral to ensuring an appropriate inspection regime is in place locally. By working collaboratively with both providers and local Healthwatch, local authority scrutiny bodies can ensure that concerns from patients and the public trigger further investigation where necessary.
The Department of Health has worked with partners to develop guidance that will support local authorities to carry out effective scrutiny. The guidance describes the new powers and duties provided by the Local Authorities (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013, and underlines the importance of all partners in the local system working together to improve the quality of services.
The guidance is due to be published in November 2013.
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 147
The Health overview and scrutiny committee (HOSC) principles published in July 2022 sets out the expectations of working together.
HOSCs can request evidence from systems and NHS bodies, and should ensure that their requests for evidence are reasonable, proportionate and relevant.
The health system has a responsibility to provide information needed for health scrutiny. Health and care providers and commissioners should respond positively and constructively to the requests for information from HOSCs. Where an NHS body cannot provide a response to a request for information, it should work with the HOSC to attempt to provide information and support where possible. ICBs should have plans and protocols in place for sharing information for the purpose of scrutiny, as this will avoid the need for continual ad-hoc decision-making when information is requested.
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 “Not yet actioned”. Table row: section 18.2 No. 150, PDF page 495.
Department of Health and Social Care says in progress (11 February 2015)
In June 2014, the Department issued guidance to local authorities on how to scrutinise local health systems. The guidance supports local government, the NHS and other local partners to understand and develop their roles in relation to health scrutiny, and ensure that it adds value for local communities. The publication of the guidance was put back in order to ensure consistency with related policy around local consultation on proposals for service reconfiguration, and to allow additional engagement with local authorities and other system partners.
The Department of Health, NHS England and Public Health England have jointly commissioned a programme of support for 2014/15 for local authorities in exercising their health scrutiny powers.
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 local authorities, 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 (27 February 2026)
This recommendation was accepted in principle by the Government.
In the January 2014 Hard Truths report, the Government said that local authority scrutiny functions had legal powers to require providers of NHS services to provide information and to attend scrutiny meetings, while local Healthwatch had the power to enter and view certain premises. The Government said that giving further powers to local authorities would be duplicative, potentially burdensome and possibly creating confusion over rules and responsibilities.
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 dated April 2025, published 27 February 2026). 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 18.2 No. 150, PDF page 495.
Earlier findings (1)
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted in principle by the Government.
In the January 2014 Hard Truths report, the Government said that local authority scrutiny functions ha legal powers to require providers of NHS services to provide information and to attend scrutiny meetings, while local Healthwatch had the power to enter and view certain premises. The Government said that giving further powers to local authorities would be duplicative, potentially burdensome and possibly creating confusion over rules and responsibilities.
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. 150, PDF page 462.
Source
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