Information standards
The Information Centre should be enabled to undertake more detailed statistical analysis of its own than currently appears to be the case.
- The Health and Social Care Information Centre (established April 2013, rebranded as NHS Digital July 2016) was given expanded statutory functions for data collection, analysis, and publication under the Health and Social Care Act 2012. NHS Digital developed significant analytical capability, including the Summary Hospital-level Mortality Indicator (SHMI), Hospital Episode Statistics analysis, and various quality dashboards.
- NHS Digital was merged into NHS England on 1 February 2023, with all data and analytical functions absorbed into the combined organisation. NHS England now operates the national healthcare data infrastructure, including analysis of Hospital Episode Statistics, patient safety events (LFPSE), clinical outcomes, and workforce data (NHS England, NHS Digital Merger, February 2023).
- Francis's concern was that the Information Centre should be enabled to undertake more detailed statistical analysis than it was able to at the time of his report. The analytical capacity of what is now NHS England's data services directorate has expanded considerably since 2013, with new tools, datasets, and analytical capabilities.
- However, as noted in F257, the merger into NHS England means the analytical function is no longer held by an independently governed body. This raises questions about whether detailed statistical analysis that might be critical of NHS performance retains the independence Francis valued, given the analytical team now sits within the organisation responsible for delivering the services being analysed.
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
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.