Information sharing
Steps must be taken to systematise the exchange of information between the Royal Colleges and the General Medical Council, and to issue guidance for use by employers of doctors to the same effect.
- The Medical Profession (Responsible Officers) Regulations 2010 require every designated body, including Royal Colleges, to appoint a responsible officer with a statutory duty to report fitness to practise concerns to the GMC, creating a formal information exchange channel (Medical Profession (Responsible Officers) Regulations 2010, SI 2010/2841).
- The GMC-CQC Joint Operational Protocol includes provisions for sharing intelligence from inspections and training data, but the Royal Colleges' information sharing with the GMC is not governed by a single formal protocol. Individual Royal Colleges maintain their own arrangements with the GMC.
- The GMC's enhanced monitoring programme, which draws on National Training Survey data and deanery reports, provides a mechanism for systemic intelligence from training environments where Royal College curricula are delivered, indirectly facilitating information exchange.
- While statutory mechanisms exist for responsible officers to report concerns, the systematised exchange of information between all Royal Colleges and the GMC that Francis envisaged — including formal guidance for employers — has been partially but not comprehensively implemented. No single published guidance document addresses information sharing between all Royal Colleges and the GMC in the systematic manner Francis recommended.
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.
GMC medical revalidation launched December 2012. All licensed doctors must demonstrate fitness to practise every five years through appraisal and evidence. Francis Report endorsed and recommended strengthening revalidation.