Recommendation F176: Openness with regulators
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Any statement made to a regulator or a commissioner in the course of its statutory duties must be completely truthful and not misleading by omission.
In brief (written by this site)
In February 2026, the Department of Health and Social Care and NHS England referred progress on this recommendation to their response on the statutory duty of candour (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team found that the government had created an offence in section 92 of the Care Act 2014 for supplying, publishing or making available false or misleading information, and noted that the NHS Standard Contract included a requirement of good faith (The Thirlwall Inquiry legal team, May 2024).
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.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted.
The Government’s response to the Inquiry, Patients First and Foremost reaffirmed a commitment to the values of openness, honesty and acceptance of challenge and when things go wrong to learn from and not conceal mistakes. There is a clear expectation that every health and care provider should abide by these values. There is a similar expectation of truthfulness between commissioners and providers – service condition 4.1 of the NHS Standard Contract is explicit that ‘Parties must at all times act in good faith towards each other’ and between providers and regulators. Also, the Care Quality Commission will assess whether providers have an open and transparent culture, backed up by effective leadership, governance and clinical involvement as part of its new approach to inspection and regulation. As set out in recommendation 182, the Government is putting in place additional measures to ensure that certain key information is truthful and not misleading. There is an existing requirement of Monitor’s licence that information provided is accurate, complete and not misleading and an expectation that licence-holders notify Monitor in the event of any incident, event or report that may raise concerns over compliance with their licence. The Care Bill contains provisions to introduce a new criminal offence applicable to care providers that supply or publish certain types of false or misleading information, where that information is required to comply with a statutory or other legal obligation.
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 21 on the statutory Duty of Candour.
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. 176, PDF page 510.
Department of Health and Social Care says in progress (11 February 2015)
The Government is putting in place a new criminal offence applicable to any care providers who supply, publish or otherwise make available certain types of information which is false or misleading, where that information is required to comply with a statutory or other legal obligation. This offence also applies to senior individuals in a provider organisation if they consent or connive in the offence. Further information is set out in the update to the response to recommendation 182.
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 healthcare providers, 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 Standard Contract included a requirement of good faith.
The Government created the offence of supplying, publishing or otherwise making available false or misleading information in section 92 of the Care Act 2014.
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 colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team, that a recommendation has been clearly implemented. Table row: section 16.2 No. 176, PDF page 476.
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