Follow up of patients
A proactive system for following up patients shortly after discharge would not only be good "customer service", it would probably provide a wider range of responses and feedback on their care.
- NHS Providers reported in February 2026 that while discharge planning has improved, systematic follow-up of patients remains inconsistent due to pressures on community and primary care (NHS Providers evidence log, February 2026).
- An academic review in February 2023 found that cultural change regarding patient follow-up and feedback was not fully embedded (Ten Years After Francis, Academic Review, February 2023).
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. Please see response to recommendation 239 for information on the Hospital Discharge policy and operating model (2020). The Hospital Discharge Service policy and operating model (August 2020) service guidance includes patient information leaflets for a variety of different circumstances, as well as staff action cards summarising the responsibilities of health and care staff in the hospital discharge process.
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.
Francis recommended systematic follow-up of patients after discharge. NHS trusts have improved discharge planning and some follow-up mechanisms exist. However, pressures on community and primary care services mean systematic post-discharge follow-up remains inconsistent, particularly for elderly patients -- the group most at risk in the Mid Staffs scandal.
View detailed findings
Discharge planning improved but systematic follow-up remains inconsistent, particularly for elderly patients.
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.