Recommendation F288: Clinical input
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Department of Health should ensure that there is senior clinical involvement in all policy decisions which may impact on patient safety and well-being.
In brief (written by this site)
In September 2024, the Department of Health and Social Care and NHS England stated that implementation was ongoing, reporting that roles including the Chief Medical Officer, Chief Nursing Officer, and Chief Scientific Adviser ensure senior clinical and scientific advice is embedded in policy making (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation and had reported arrangements to ensure access to clinical advice (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
Government response
Accepted.
The Department of Health has put in place arrangements to ensure that it has access to clinical advice on the full range of issues it deals with. The mechanisms employed include direct employment of clinical advisers where appropriate, and access to advice from senior clinicians elsewhere in the system. In addition to these formal mechanisms, the Department’s programme of connecting to front-line practitioners and organisations will, we believe, provide the basis for long-term informal networks of advice that officials will be able to draw upon when developing policy.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
There are several roles within the NHS England and government that ensure senior clinical and scientific advice is embedded in policy making. Examples include:
The Chief Medical Officer provider public health and clinical advice to ministers in the Department and across Government.
The Chief Nursing Officer is accountable for providing clinical and professional leadership for all Nurses and Midwives and Nursing associates, as well as advising the Secretary of State.
Chief Scientific Adviser with responsibility for the Department’s research and development.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented – Ongoing”. Table row: section 18.2 No. 288, PDF page 578.
Department of Health and Social Care states no delivery position (11 February 2015)
No further update is required. Please see response to the recommendation in Hard Truths
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
In the January 2014 Hard Truths report, the Government said the Department of Health had put in place arrangements to ensure access to clinical advice, including direct employment of clinical advisers where appropriate, access to advice from senior clinicians elsewhere in the system, and a programme of connecting to front-line practitioners and organisations.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 288, PDF page 530-531.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding