Recommendation F245: Board accountability
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Each provider organisation should have a board level member with responsibility for information.
In brief (written by this site)
In commentary published in February 2026, the Department of Health and Social Care and NHS England reported that the Records Management Code of Practice confirms a designated staff member of appropriate seniority should hold lead responsibility for records management (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation in principle, leaving trusts to agree individual board roles locally while the department supported executive directors taking principal responsibility for providing information (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.
Government response
Accepted in principle.
Boards must have both reliable intelligence to support the delivery of high quality care and the skills and training needed to use that intelligence appropriately.
While it is for Trusts to agree the roles and responsibilities of individual Board members locally, in line with this recommendation the Department of Health supports:
• the NHS Leadership Academy who set out clear roles for Executive Directors in taking ‘… principal responsibility for providing accurate, timely and clear information to the board’ as part of The Healthy NHS Board (NHS Leadership Academy, 2013); and
• forums such as the Chief Clinical Information Officers Leaders Network, established by eHealth Insider, with the support of the Royal College of Physicians, to support doctors, nurses and allied health professionals who are taking the lead on information and its use within organisations.
The Department also support programmes that embed informatics within the work of non- board members including clinicians and staff. These include the Clinical Leaders Network’s Embedding Informatics in Clinical Education, an online tool to train about the use of informatics in clinical work.
In addition, the Care Quality Commission’s new inspection process includes an assessment of whether a provider is well led. In A New Start (Care Quality Commission, July 2013) they stated that ‘well led’ providers will have effective leadership that listens and learns from information about services such that they are able to have open discussions about the quality of services that are evidence based. The Care Quality Commission will start inspecting all acute service providers from 2014 using this new process.
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)
NHS England published a Records Management Code of Practice which confirms that “Records management should be recognised as a specific corporate responsibility within every organisation” and that “A designated member of staff of appropriate seniority, ideally with suitable records management qualifications, should have lead responsibility for records management within the organisation.”
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. 245, PDF page 555-556.
Department of Health and Social Care states no delivery position (11 February 2015)
This recommendation is aimed at provider organisations and the response is unchanged.
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 principle.
In the January 2014 Hard Truths report, the Government said that it was for trusts to agree the roles and responsibilities of individual Board members locally. However, the Department of Health said it supported clear roles for Executive Directors in taking principal responsibility for providing accurate, timely and clear information to the board.
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. 245, PDF page 512.
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