F236 Response Accepted AI-assessed

Identification of who is responsible for the patient

Recommendation

Hospitals should review whether to reinstate the practice of identifying a senior clinician who is in charge of a patient's case, so that patients and their supporters are clear who is in overall charge of a patient's care.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
The government accepted this recommendation in November 2013. While general government reports in 2013 and 2015 indicated good progress on the Francis recommendations overall, and an academic review in February 2023 noted structural and legislative changes were largely delivered, no specific evidence has been identified demonstrating that hospitals have reviewed or reinstated the practice of identifying a senior clinician in charge of a patient's case. The most recent specific evidence is from 2015.
How was this assessed?
Assessed by gemini-2.5-flash on 24 Mar 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.legislation.gov.uk, hansard.parliament.uk
This recommendation requires implementation across many organisations. The assessment reflects central policy response, not adoption in individual organisations.
Jurisdiction
England
Response
Accepted
Accepted Department of Health and Social Care
19 Nov 2013

The 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

Read Full Response
Note: 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.
Published Evidence

Published assessments of implementation progress from inspectorates, select committees, official progress reports, and other sources. Check the source type badge to see whether each assessment is independent or government self-reported.

Reasonable Progress
06 Feb 2023
Academic Review - Ten Years After Francis

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.

University of Birmingham: Ten years after Francis View Source
Good Progress
11 Feb 2015
UK Government - Culture Change in 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.

View Source
Good Progress
19 Nov 2013
UK Government - Hard Truths Vol 1 & 2

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.

View Source
Source
Inquiry Mid Staffs Inquiry
Report Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry 06 Feb 2013
View Source
Responsible Bodies
Healthcare providers Primary
Themes & Tags
No person-centred care Care plan failures Elderly Care Patient Care Accountability
Recommendation age 13.1 yrs
Last formal update 4508 days ago