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.
- The NHS Standard Contract requires provider organisations to participate in national clinical audits (NCAPOP) and submit data to national datasets including Hospital Episode Statistics, the Mental Health Services Data Set, and other mandatory collections. This establishes a contractual obligation to allocate resources for data collection.
- NHS England has invested in digital infrastructure to support data collection, including nearly £2 billion for EPR implementation across all trusts. The Data Security and Protection Toolkit (DSPT) includes requirements for organisations to allocate appropriate resources to information governance and data quality.
- However, data quality challenges persist. Clinical coding accuracy varies between trusts, and the resources allocated to clinical coding teams and data quality assurance vary significantly. GIRFT reports have consistently identified clinical coding quality as a concern affecting the reliability of comparative statistics.
- The move from the National Reporting and Learning System (NRLS) to the Learn from Patient Safety Events (LFPSE) service required significant investment in new data collection systems, completed with NRLS decommissioned on 30 June 2024. While national infrastructure investment has been substantial, local resource allocation for data collection remains variable.
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.
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.