Hygiene
All staff and visitors need to be reminded to comply with hygiene requirements. Any member of staff, however junior, should be encouraged to remind anyone, however senior, of these.
- NHS England published updated guidance for NHS Employers on uniforms and workwear in 2023 to support effective hand hygiene (Uniforms and workwear: guidance for NHS employers, NHS England, April 2023).
- The Department of Health and Social Care and NHS England stated in April 2025 that a National infection prevention and control board assurance framework is in place (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- The Health and Social Care Act 2008 Code of Practice contains specific requirements relating to uniform policies and infection control (Health and Social Care Act 2008: code of practice on the prevention and control of infections, DHSC, updated 2022).
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
Progress Timeline
DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Implemented - Ongoing. NHS England offer guidance on infection control for NHS healthcare staff of all disciplines in all settings. This was last updated in 2024 and includes: - A National infection prevention and control manual for England, an evidence-based practice manual for use by all those involved in care provision in England - A National infection prevention and control board assurance framework - An A-Z pathogen resource NHS England additionally publishes guidance for NHS Employers on Uniforms and workwear (2023).This supports the specific requirements of the Health and Social Care Act 2008 Code of Practice relating to uniform and workwear policies, and the need to ensure that they support effective hand hygiene.
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.