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CQC and Monitor coordination

Morecambe Bay Investigation · Report of the Morecambe Bay Investigation · Issued 3 March 2015 · Addressed to: CQC

Government responseDepartment of Health and Social Care: Accepted (Jul 2015)

DeliveryDHSC and NHS England say completed (Feb 2026)DHSC states no delivery position (May 2024)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

We considered carefully the effectiveness of separating organisationally the regulation of quality by the Care Quality Commission from the regulation of finance and performance by Monitor, given the close inter-relationship between Trust decisions in each area. However, we were persuaded that there is more to be gained than lost by keeping regulation separated in this way, not least that decisions on safety are not perceived to be biased by their financial implications. The close links, however, require a carefully coordinated approach, and we recommend that the organisations draw up a memorandum of understanding specifying roles, relationships and communication. Action: Monitor, the Care Quality Commission, the Department of Health.

Morecambe Bay Investigation, Report of the Morecambe Bay Investigation · 3 Mar 2015 Source PDF →

Published evidence summary

AI-generated evidence summary

In February 2026, the Department of Health and Social Care and NHS England stated that the recommendation was implemented and closed, confirming that the February 2015 memorandum of understanding between Monitor and the Care Quality Commission still stood and that an information sharing agreement was planned (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team found evidence that the measure had been clearly implemented (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.

Government response

●Department of Health and Social Care · Accepted · 16 Jul 2015

Words of: Department of Health, Learning not blaming (Cm 9113), government response to the Morecambe Bay Investigation and two other reports, July 2015

87. We accept this recommendation. Closer working links have been established and will be developed further. 88. An updated Memorandum of Understanding between Monitor and the Care Quality Commission was published on 26 February 2015. It describes what they intend to achieve and their continued commitment to working together. Both organisations have improved how they work together in areas including: Monitor's assessment process and significant transaction reviews, management of Care Quality Commission registration requirements, management of risk, and joint escalation and enforcement of the new licensing regime. The Care Quality Commission and Monitor have clarified their roles in the Single Failure Regime, including Special Measures. Work is ongoing to further improve joint working and the sharing of information. In addition, the Care Quality Commission will work jointly with Monitor and the NHS Trust Development Authority to develop proposals to assess the efficiency of providers as part of its inspection and rating process. 89. The Care Quality Commission and Monitor will keep this Memorandum of Understanding under regular review and will update it as relevant to reflect the Care Quality Commission's new role in assessing Foundation Trusts' use of resources and any other changes to the functions of the two organisations.

Response document: Learning not blaming: The government response to the Freedom to Speak Up consultation, the Public Administration Select Committee report 'Investigating Clinical Incidents in the NHS', and the Morecambe Bay Investigation

Site note: This is the Department of Health's response, "Learning not blaming" (Cm 9113, July 2015), to the Morecambe Bay Investigation and two other reports. The department has been the Department of Health and Social Care since January 2018, and the rows are filed under that name. Every word is the department's, including where it reports what another body has done or will do.

Site note: The recommendation is addressed to the Care Quality Commission; the passage is the Department of Health's account, not that body's.

Delivery

●DHSC and NHS England say completed · 27 Feb 2026

The Thirlwall Inquiry has noted action taken in response to this recommendation.

An MoU between Monitor and the CQC was published on 26 February 2015. Although Monitor has come together, first with the NHS Trust Development Authority (TDA) and then with NHS England, the MoU still stands. As part of the Freedom to Speak UP (FTSU) Escalation work, NHS England is planning to develop an Informational Sharing Agreement with CQC that explains how NHS England and CQC will work together on escalated concerns to ensure consistency in practice.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

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 – Closed”. Table row: section 23.2 No. 33, PDF page 651.

●DHSC states no delivery position · 15 May 2024

Although Monitor has come together, first with the TDA and then with NHS England, the MoU still stands.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024), The Department of Health and Social Care

Site note: DHSC's own comments on progress, supplied to the Thirlwall Inquiry in February 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). They are not a finding of the Inquiry. Table row: section 20.2 No. 33, PDF page 615.

What other bodies have found

In their own words. These do not change the delivery statement above.

●Thirlwall Inquiry legal team · 15 May 2024

Department of Health response (July 2015):

Accept this recommendation.

“An updated Memorandum of Understanding between Monitor and the Care Quality Commission was published on 26 February 2015” (p. 87)

“Both organisations have improved how they work together in areas including: Monitor’s assessment process and significant transaction reviews, management of Care Quality Commission registration requirements, management of risk, and joint escalation and enforcement of the new licensing regime.” (p. 88)

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024)

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 colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team, that a recommendation has been clearly implemented. Table row: section 20.2 No. 33, PDF page 615.

How this page is built

The recommendation and the government responses are verbatim from primary documents. Delivery statements and other bodies' findings are shown in their own words, each with its source. The summary is written by this site and labelled as such. The Index does not paraphrase sources or characterise intent; it records what has been published.