Improving and assuring accuracy
There is a demonstrable need for an accreditation system to be available for healthcare-relevant statistical methodologies. The power to create an accreditation scheme has been included in the Health and Social Care Act 2012, it should be used as soon as practicable.
- Section 280 of the Health and Social Care Act 2012 inserted powers for the Secretary of State to establish an accreditation scheme for healthcare information methodology, as Francis noted. However, these powers have not been exercised to create a formal accreditation scheme for statistical methodologies.
- The Office for Statistics Regulation (OSR) provides independent review and accreditation of official statistics, and has accredited SHMI as meeting the Code of Practice for Statistics. This provides quality assurance for individual statistical products but is not equivalent to the broader healthcare-specific methodological accreditation scheme Francis envisaged.
- Individual statistical methodologies are reviewed through academic peer review, expert advisory groups, and public consultation (for example, SHMI methodology is reviewed by an expert advisory group). But there is no systematic accreditation system covering all healthcare-relevant statistical methodologies.
- The power to create an accreditation scheme exists in legislation but has not been used. This recommendation remains partially fulfilled through OSR's existing official statistics accreditation framework, but the healthcare-specific methodological accreditation scheme Francis recommended has not been established.
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.