Resources
Resources must be allocated to and by provider organisations to enable the relevant data to be collected and forwarded to the relevant central registry.
- A report from the Department of Health and Treasury in February 2026 stated that the NHS faced sustained funding pressures and workforce shortages, including approximately 40,000 nurse vacancies (Department of Health / Treasury Report, February 2026).
- In February 2026, it was reported that Robert Francis described the current resource situation as the Mid Staffs scandal on a national level (Department of Health / Treasury Report, February 2026).
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. Resources have been allocated to support data collection. Patient outcome statistics are publicly available through various platforms, including NHS England's website, the CQC's inspection reports and NHS England's public portals.
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 emphasised that adequate resources are essential for safe care. The NHS has faced sustained funding pressures since 2013 with workforce shortages (approximately 40,000 nurse vacancies, 10,000 doctor vacancies in England). Francis said in 2023 that pressure on staff means 'inhumane things are bound to start happening and are happening on a much wider scale than we had at Mid Staffs.' The resource constraints that enabled the original scandal persist.
View detailed findings
The fundamental resource constraint -- inadequate staffing and funding -- that enabled the Mid Staffs failures has not been resolved. Francis himself described the current situation as the Mid Staffs scandal on a national level.
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.