Access for public and patient comments
While there are likely to be many different gateways offered through which patient and public comments can be made, to avoid confusion, it would be helpful for there to be consistency across the country in methods of access, and for the output to be published in a manner allowing fair and informed comparison between organisations.
- The NHS Standard Contract requires providers to publish complaints monitoring reports under Schedule 6 (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- NHS England stated in April 2025 that the Friends and Family Test is not intended to provide data for comparing different organisations (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- No further published evidence has been identified since April 2025.
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. Article 4 of the NHS Constitution states that the NHS will actively encourage feedback from the public, patients and staff, welcome it and use it to improve its services. Organisations should regularly promote their wish to hear from service users and show how they use learning from all feedback (including complaints) to improve services. After being launched in April 2013, the Friends and Family Test (FFT) was rolled out in phases to most NHS-funded services in England over a two-year period, and now gives all patients, users of services, their carers and loved ones the opportunity to leave feedback on their care and treatment, alongside other means of feeding back as set out on the NHS website. The NHS Standard Contract requires providers to publish complaints monitoring reports (schedule 6). Note that as a continuous feedback tool, the FFT is not intended to provide data that can be used to compare different organisations. This is to encourage a focus on good quality feedback and opportunities to identify good practice.
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.