Recommendation F250: Accountability for quality accounts
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
It should be a criminal offence for a director to sign a declaration of belief that the contents of a quality account are true if it contains a misstatement of fact concerning an item of prescribed information which he/she does not have reason to believe is true at the time of making the declaration.
In brief (written by this site)
The Inquiry called for a criminal offence for directors signing false quality account declarations. In commentary of September 2024, published in February 2026, the Department of Health and Social Care (DHSC) and NHS England stated that the Thirlwall Inquiry had noted action taken in response to the recommendation (DHSC and NHS England, Feb 2026). That inquiry's legal team recorded in May 2024 that the government enacted a wider offence of false or misleading information under section 92 of the Care Act 2014, applying to care providers and to senior individuals who consent to or connive in the offence (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 5 Oct 2026. The record below is the sources' own words.
Government response
Accepted in principle.
We will use the consultation on False or Misleading Information to consider whether the False or Misleading Information offence should be applied to the information on quality accounts.
The Care Bill proposes a new offence where care providers give false or misleading information. This will give providers an additional incentive to ensure data and the information it provides are accurate. The offence will aid transparency and accountability in the provision of care so that regulators, commissioners and the public have a more accurate picture about a provider’s performance. The offence will apply to those care providers that falsify certain types of management and performance information and fail to exercise due diligence. Providers that make a genuine administrative error would not be convicted, providing they have processes and procedures in place to demonstrate they took all reasonable steps and exercised due diligence.
The offence will allow for the prosecution of directors and senior individuals, where the offence has been committed with their consent or connivance or through their neglect, and a successful prosecutions has been brought against the provider.
Our current intention is that regulations will limit the application of this offence in the first instance to providers of NHS funded secondary care and, more specifically, to the patient level information on outpatient, elective and accident and emergency activity that they are required to provide to the Health and Social Care Information Centre. However, we intend to test and confirm our thinking through further consultation before draft regulations are laid.
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)
The Thirlwall Inquiry has noted action taken in response to this recommendation following the conclusion of the Mid-Staffordshire Inquiry 2013.
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. 250, PDF page 558.
Site note: DHSC and NHS England's entry for this recommendation says that the Thirlwall Inquiry noted action taken on it. The entry gives no other account of what was done.
Department of Health and Social Care says partially delivered (11 February 2015)
The Care Act 2014 has put in place a new criminal offence applicable to care providers who supply, publish or otherwise make available certain types of information that 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 to or connive in the offence.
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.
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 in principle by the Government.
The Government enacted a wider offence of ‘false or misleading information’ in section 92 of the Care Act 2014. The offence applied to providers, as well as senior individuals in a provider organisation if they consented to or connived in the offence.
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. 250, PDF page 514.
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