Recommendation BRIS-126: Clearly distinguish between obligatory and aspirational national clinical care standards.
From Bristol Heart Inquiry — Final Report, published 18 July 2001.
Recommendation
Such standards for clinical care as are established should distinguish clearly between those which are obligatory and must be observed, and those to which the NHS should aspire over time.
Government response
No government response to this recommendation is on the record yet.
Delivery
DHSC and NHS England say not accepted (27 February 2026)
This recommendation was not accepted by the Government.
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 “Not accepted”. Table row: section 6.2 No. 126, PDF page 127-128.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
The Government rejected this recommendation.
In its January 2002 response, the Department of Health said that where National Institute for Clinical Excellence guidance existed it would become the standard. Advice from professional bodies which went beyond National Institute for Clinical Excellence guidance could be regarded as aspirational.
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 6.2 No. 126, PDF page 113.
Themes and tags
Who has spoken
- DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding