Public Inquiry Recommendations

L71 Not Accepted

Leveson Inquiry (2012)

Aggravated and Exemplary Damages

The Report of the Law Commission on Aggravated, Exemplary and Restitutionary Damages should be adopted in relation to its recommendations that legislation should provide that: (a) aggravated damages should only …

- The Law Commission Report on Aggravated, Exemplary and Restitutionary Damages (Law Com No. 247, 1997) recommended legislative reform of the damages framework. The Leveson …

L72 Accepted

Leveson Inquiry (2012)

Exemplary Damages for Media Torts

Exemplary damages (whether so described or renamed as punitive damages) should be available for actions for breach of privacy, breach of confidence and similar media torts, as well as for …

- Sections 34-39 of the Crime and Courts Act 2013 provide for exemplary damages against publishers not belonging to a recognised press regulatory body. These …

L73 Not Accepted

Leveson Inquiry (2012)

Civil Procedure Rules on Costs

The Civil Procedure Rules should be amended to require the court, when considering the appropriate order for costs at the conclusion of proceedings, to take into account the availability of …

- Section 40 of the Crime and Courts Act 2013 was enacted to provide costs protections linked to membership of a recognised press regulator and …

L74 Not Accepted

Leveson Inquiry (2012)

Qualified One Way Costs Shifting

In the absence of the provision of an approved mechanism for dispute resolution, available through an independent regulator without cost to the complainant, together with an adjustment to the Civil …

- This recommendation proposed enhanced legal aid or a cost-shifting mechanism for individuals bringing claims against publishers, in the absence of a recognised regulatory arbitration …

L75 Accepted

Leveson Inquiry (2012)

Discontinue Off-the-record Term

The term 'off-the-record briefing' should be discontinued. The term 'non-reportable briefing' should be used to cover a background briefing which is not to be reported, and the term 'embargoed briefing' …

- The College of Policing published Authorised Professional Practice (APP) on media relations, which includes guidance on the conduct of briefings and the terms under …

L76 Accepted

Leveson Inquiry (2012)

ACPO Media Contact Recording

It should be mandatory for ACPO rank officers to record all of their contact with the media, and for that record to be available publicly for transparency and audit purposes. …

- The College of Policing Authorised Professional Practice on media relations requires chief officers to record contacts with the media and for these records to …

L77 Accepted

Leveson Inquiry (2012)

Police Media Contact Rule

The simple rule included within the 'Interim ACPO Guidance for Relationships with the Media' should be adopted as good practice. This is: "Police officers and staff should ask: 'am I …

- The College of Policing published Authorised Professional Practice (APP) on media relations which adopted the principle that officers should consider whether there is a …

L78 Accepted

Leveson Inquiry (2012)

PNC Access Auditing

The Police Service should re-examine the rigour of the auditing process and the frequency of the conduct of audits in relation to access to the Police National Computer (PNC). Additional …

- The College of Policing APP on information management covers access to the Police National Computer (PNC), including requirements for auditing and access controls (College …

L79 Accepted

Leveson Inquiry (2012)

ACPO Guidance on Hospitality

The recent ACPO Guidance should more specifically spell out the dangers of consuming alcohol in a setting of casual hospitality (without necessarily specifying a blanket ban).

- The College of Policing published Authorised Professional Practice on media relations which includes guidance on hospitality in the context of police-media interactions (College of …

L80 Accepted

Leveson Inquiry (2012)

ACPO Post-employment Restrictions

Consideration should be given to the terms upon which ACPO rank officers are appointed and, in particular, whether these terms should include some limitation upon the nature of any employment …

- The College of Policing and NPCC have adopted guidance on standards of professional behaviour applying to senior officers, including requirements around business interests and …

L81 Accepted

Leveson Inquiry (2012)

Enhanced Whistleblower Protection

An enhanced system for protection of whistleblowers and for providing assistance for the Police Service on general ethical issues should at least comprise the following: (a) greater prominence should be …

- The Independent Police Complaints Commission (IPCC) was replaced by the Independent Office for Police Conduct (IOPC) on 8 January 2018 under the Policing and …

L82 Accepted in Part

Leveson Inquiry (2012)

Party Policy on Press Relations

As a first step, political leaders should reflect constructively on the merits of publishing on behalf of their party a statement setting out, for the public, an explanation of the …

- The UK Government publishes quarterly ministerial transparency data including details of meetings with newspaper and other media proprietors, editors and senior executives (GOV.UK, Ministers' …

L83 Accepted

Leveson Inquiry (2012)

Disclosure of Media Contacts

Party Leaders, Ministers and Front Bench Opposition spokesmen should consider publishing: (a) the simple fact of long term relationships with media proprietors, newspaper editors or senior executives which might be …

- The UK Government publishes quarterly ministerial transparency data including details of meetings between ministers and media proprietors, newspaper editors and senior media executives (GOV.UK, …

L84 Accepted

Leveson Inquiry (2012)

Immediate Transparency Need

The suggestions that I have made in the direction of greater transparency about meetings and contacts should be considered not just as a future project but as an immediate need, …

- The UK Government has published quarterly ministerial transparency data continuously since 2010, including details of meetings with media proprietors, editors and senior executives (GOV.UK, …

L85 Accepted

Leveson Inquiry (2012)

Plurality Focus on News

The particular public policy goals of ensuring that citizens are informed and preventing too much influence in any one pair of hands over the political process are most directly served …

- Ofcom developed a Measurement Framework for Media Plurality, published in 2015, which set out metrics for assessing the sufficiency of plurality across news and …

L86 Accepted

Leveson Inquiry (2012)

Include Online in Plurality

Online publication should be included in any market assessment for consideration of plurality.

- Ofcom's Measurement Framework for Media Plurality, published in 2015, explicitly includes online news consumption in its assessment of media plurality (Ofcom, Measurement Framework for …

L87 Accepted

Leveson Inquiry (2012)

Plurality Measurement Framework

Ofcom and the Government should work, with the industry, on the measurement framework, in order to achieve as great a measure of consensus as is possible on the theory of …

- Ofcom published its Measurement Framework for Media Plurality in 2015, developed in consultation with industry, setting out a methodology for measuring plurality across media …

L88 Accepted

Leveson Inquiry (2012)

Plurality Thresholds Lower Than Competition

The levels of influence that would give rise to concerns in relation to plurality must be lower, and probably considerably lower, than the levels of concentration that would give rise …

- Ofcom's Measurement Framework for Media Plurality (2015) distinguishes between competition concerns (market power) and plurality concerns (diversity of viewpoints), noting that plurality concerns may …

L89 Accepted

Leveson Inquiry (2012)

Full Menu of Plurality Remedies

Ofcom has presented the Inquiry and the Government with a full menu of potential remedies, and it has not been argued or suggested that any of them are inappropriate in …

- Ofcom's Measurement Framework for Media Plurality (2015) identified a range of potential remedies for addressing plurality concerns, including structural remedies (divestiture, ownership limits), behavioural …

L90 Accepted

Leveson Inquiry (2012)

Periodic Plurality Reviews

The Government should consider whether periodic plurality reviews or an extension to the public interest test within the markets regime in competition law is most likely to provide a timely …

- Ofcom publishes annual Media Nations reports which assess the state of UK media markets including news consumption and plurality indicators, providing a form of …

L91 Accepted

Leveson Inquiry (2012)

Media Merger Referral Consultation

Before making a decision to refer a media merger to the competition authorities on public interest grounds, the Secretary of State should consult relevant parties as to the arguments for …

- The Enterprise Act 2002, sections 42-58, require the Secretary of State to issue an intervention notice when referring a media merger on public interest …

L92 Accepted

Leveson Inquiry (2012)

Secretary of State Media Merger Decisions

The Secretary of State should remain responsible for public interest decisions in relation to media mergers. The Secretary of State should be required either to accept the advice provided by …

- The Enterprise Act 2002 provides that the Secretary of State retains responsibility for public interest decisions in media mergers, including issuing intervention notices under …

F1 Accepted

Mid Staffs Inquiry (2013)

Implementing the recommendations

It is recommended that: All commissioning, service provision regulatory and ancillary organisations in healthcare should consider the findings and recommendations of this report and decide how to apply them to …

- The government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) in November 2013, responding to all 290 Francis recommendations. Volume 2 …

F2 Accepted

Mid Staffs Inquiry (2013)

Putting the patient first

The NHS and all who work for it must adopt and demonstrate a shared culture in which the patient is the priority in everything done. This requires: A common set …

- The NHS Constitution for England was revised in 2013 and again on 27 July 2015, incorporating updated values including "patients come first in everything …

F3 Accepted

Mid Staffs Inquiry (2013)

Clarity of values and principles

The NHS Constitution should be the first reference point for all NHS patients and staff and should set out the system's common values, as well as the respective rights, legitimate …

- The NHS Constitution for England, first published in 2009 under the Health Act 2009, sets out patients' rights, staff rights, and the values of …

F4 Accepted

Mid Staffs Inquiry (2013)

Clarity of values and principles

The core values expressed in the NHS Constitution should be given priority of place and the overriding value should be that patients are put first, and everything done by the …

- The NHS Constitution for England states "patients come first in everything we do" as the opening principle under the value "Working together for patients" …

F5 Accepted

Mid Staffs Inquiry (2013)

Clarity of values and principles

In reaching out to patients, consideration should be given to including expectations in the NHS Constitution that: Staff put patients before themselves; They will do everything in their power to …

- The NHS Constitution for England includes a section titled "Staff: your responsibilities" which states that staff should aim to "provide all patients with safe …

F6 Accepted

Mid Staffs Inquiry (2013)

Clarity of values and principles

The handbook to the NHS Constitution should be revised to include a much more prominent reference to the NHS values and their significance.

- The Handbook to the NHS Constitution for England was revised on 27 July 2015, providing "greater detail on the rights and pledges contained in …

F7 Accepted in Part

Mid Staffs Inquiry (2013)

Clarity of values and principles

All NHS staff should be required to enter into an express commitment to abide by the NHS values and the Constitution, both of which should be incorporated into the contracts …

- The NHS Constitution for England states that staff should "follow all guidance, standards and codes relevant to your role" and that staff have "a …

F8 Accepted

Mid Staffs Inquiry (2013)

Clarity of values and principles

Contractors providing outsourced services should also be required to abide by these requirements and to ensure that staff employed by them for these purposes do so as well. These requirements …

- The NHS Constitution for England states it applies to "private and voluntary sector providers supplying NHS services" and covers staff "whether in public, private …

F9 Accepted in Part

Mid Staffs Inquiry (2013)

Fundamental standards of behaviour

The NHS Constitution should include reference to all the relevant professional and managerial codes by which NHS staff are bound, including the Code of Conduct for NHS Managers.

- The NHS Constitution for England states that staff have "a duty to accept professional accountability and maintain the standards of professional practice as set …

F10 Accepted in Part

Mid Staffs Inquiry (2013)

Fundamental standards of behaviour

The NHS Constitution should incorporate an expectation that staff will follow guidance and comply with standards relevant to their work, such as those produced by the National Institute for Health …

- The NHS Constitution for England states that staff should "follow all guidance, standards and codes relevant to your role, subject to any more specific …

F11 Accepted

Mid Staffs Inquiry (2013)

Fundamental standards of behaviour

Healthcare professionals should be prepared to contribute to the development of, and comply with, standard procedures in the areas in which they work. Their managers need to ensure that their …

- The government stated in Hard Truths (November 2013) that it supported the development of evidence-based standard procedures and that professional bodies including royal colleges …

F12 Accepted

Mid Staffs Inquiry (2013)

Fundamental standards of behaviour

Reporting of incidents of concern relevant to patient safety, compliance with fundamental standards or some higher requirement of the employer needs to be not only encouraged but insisted upon. Staff …

- The statutory duty of candour was introduced through Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, requiring registered …

F13 Accepted

Mid Staffs Inquiry (2013)

The nature of standards

Standards should be divided into: Fundamental standards of minimum safety and quality – in respect of which non-compliance should not be tolerated. Failures leading to death or serious harm should …

- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 introduced fundamental standards divided into regulatory requirements enforceable by CQC, including person-centred care …

F14 Accepted in Part

Mid Staffs Inquiry (2013)

The nature of standards

In addition to the fundamental standards of service, the regulations should include generic requirements for a governance system designed to ensure compliance with fundamental standards, and the provision and publication …

- Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 establishes a fundamental standard for "Good governance," requiring providers to …

F15 Accepted in Part

Mid Staffs Inquiry (2013)

The nature of standards

All the required elements of governance should be brought together into one comprehensive standard. This should require not only evidence of a working system but also a demonstration that it …

- Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires providers to have systems and processes that enable them …

F16 Accepted

Mid Staffs Inquiry (2013)

Responsibility for setting standards

The Government, through regulation, but after so far as possible achieving consensus between the public and professional representatives, should provide for the fundamental standards which should define outcomes for patients …

- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 established fundamental standards defining outcomes for patients that must be avoided. Regulations 9-20 …

F17 Accepted in Part

Mid Staffs Inquiry (2013)

Responsibility for setting standards

The NHS Commissioning Board together with Clinical Commissioning Groups should devise enhanced quality standards designed to drive improvement in the health service. Failure to comply with such standards should be …

- NHS England (formerly the NHS Commissioning Board) publishes quality standards and commissioning guidance. The NHS Outcomes Framework set out national outcome goals for the …

F18 Accepted

Mid Staffs Inquiry (2013)

Responsibility for setting standards

It is essential that professional bodies in which doctors and nurses have confidence are fully involved in the formulation of standards and in the means of measuring compliance.

- NICE involves professional bodies, clinical experts and patient representatives in the development of guidelines and quality standards through its established guideline development process, including …

F19 Not Accepted

Mid Staffs Inquiry (2013)

Gaps between the understood functions of separate regulators

There should be a single regulator dealing both with corporate governance, financial competence, viability and compliance with patient safety and quality standards for all trusts.

- The government did not accept the recommendation for a single regulator combining financial and quality oversight. Hard Truths (November 2013) stated that CQC and …

F20 Accepted in Part

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

The Care Quality Commission should be responsible for policing the fundamental standards, through the development of its core outcomes, by specifying the indicators by which it intends to monitor compliance …

- CQC is responsible for monitoring and enforcing compliance with the fundamental standards set out in the Health and Social Care Act 2008 (Regulated Activities) …

F21 Accepted in Part

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

The regulator should have a duty to monitor the accuracy of information disseminated by providers and commissioners on compliance with standards and their compliance with the requirement of honest disclosure. …

- CQC has a statutory duty under the Health and Social Care Act 2008 to assess whether providers are meeting the fundamental standards, and its …

F22 Accepted in Part

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

The National Institute for Health and Clinical Excellence should be commissioned to formulate standard procedures and practice designed to provide the practical means of compliance, and indicators by which compliance …

- NICE publishes clinical guidelines, quality standards, and technology appraisals that provide evidence-based guidance on compliance with standards. NICE quality standards include specific, measurable statements …

F23 Accepted

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

The measures formulated by the National Institute for Health and Clinical Excellence should include measures not only of clinical outcomes, but of the suitability and competence of staff, and the …

- NICE has published quality standards and clinical guidelines covering clinical outcomes across a range of specialties (NICE, www.nice.org.uk). - NICE published safe staffing guideline …

F24 Accepted

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

Compliance with regulatory fundamental standards must be capable so far as possible of being assessed by measures which are understood and accepted by the public and healthcare professionals.

- CQC's five key questions — Safe, Effective, Caring, Responsive, and Well-led — are designed to be understood by the public and professionals. CQC publishes …

F25 Accepted

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

It should be considered the duty of all specialty professional bodies, ideally together with the National Institute for Health and Clinical Excellence, to develop measures of outcome in relation to …

- NICE works with specialist professional bodies and royal colleges in developing clinical guidelines and quality standards (NICE guidelines process, www.nice.org.uk). - Individual royal colleges …

F26 Accepted

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

In policing compliance with standards, direct observation of practice, direct interaction with patients, carers and staff, and audit of records should take priority over monitoring and audit of policies and …

- CQC's inspection model, introduced from October 2014 under the Chief Inspector of Hospitals, prioritises direct observation of care, interviews with patients and staff, and …

F27 Accepted

Mid Staffs Inquiry (2013)

Responsibility for regulating and monitoring compliance

The healthcare systems regulator should promote effective enforcement by: use of a low threshold of suspicion; no tolerance of non-compliance with fundamental standards; and allowing no place for favourable assumptions, …

- CQC's enforcement policy states that it will take action proportionate to the seriousness of any breach and that it has "zero tolerance" of breaches …

F28 Accepted

Mid Staffs Inquiry (2013)

Sanctions and interventions for non-compliance

Zero tolerance: A service incapable of meeting fundamental standards should not be permitted to continue. Breach should result in regulatory consequences attributable to an organisation in the case of a …

- The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 22, created a criminal offence where a registered person fails to comply …