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F34

Interim measures

Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: CQC

Government responseDepartment of Health and Social Care: Accepted in part (Nov 2013)

DeliveryDHSC and NHS England state no delivery position (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

Where a provider is under regulatory investigation, there should be some form of external performance management involvement to oversee any necessary interim arrangements for protecting the public.

Mid Staffs Inquiry, Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · 6 Feb 2013 Source PDF →

Published evidence summary

AI-generated evidence summary

In commentary from September 2024 published in February 2026, the Department of Health and Social Care and NHS England stated that "current arrangements meet this recommendation", explaining that the national Recovery Support Programme had replaced earlier special measures regimes to assist trusts facing difficult challenges (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that the government had originally accepted the recommendation in principle, citing previous updates regarding enforcement notices, improvement directors, and buddying arrangements (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.

Report-level response context

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.

Government response

●Department of Health and Social Care · Accepted in part · 19 Nov 2013

Speaker not recorded. Source: Department of Health, Hard Truths: the Journey to Putting Patients First, volume 2 (Cm 8777-II), November 2013

Accepted in principle.
It remains the responsibility of providers’ Boards to identify and resolve risks to patients swiftly. However, where there are significant issues that require action the Care Quality Commission will issue an enforcement notice and it is the roles of Monitor or the NHS Trust Development Authority to ensure that this is complied with.
The response to recommendation 19 outlines a single failure regime that can be enacted where risks to quality and patient safety are identified. As part of that regime, the Care Quality Commission, the NHS Trust Development Authority or Monitor will work together, with the Trust and its commissioners, to ensure that where concerns are raised, the Trust acts swiftly to resolve them and to protect patients.

Extract from: Hard Truths: The Journey to Putting Patients First. Volume Two of the Government Response to the Mid Staffordshire NHS Foundation Trust Public Inquiry: Response to the Inquiry's Recommendations

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.

Delivery

●DHSC and NHS England state no delivery position · 27 Feb 2026

While the arrangements for external performance management have evolved since the time of the recommendation, current arrangements meet this recommendation.

Please see our response to recommendation 31 above for information on the NHS Oversight Framework.

The national Recovery Support Programme (RSP) replaces the previous special measures programmes and will provide a collaborative, ICB-focused approach for supporting those trusts and ICBs with the toughest challenges. ICBs and trusts will get intensive support to use all their levers to address the often complex, historical problems they face, and embed lasting solutions.

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 “Superseded”. Table row: section 18.2 No. 34, PDF page 441.

●Department of Health and Social Care says in progress · 11 Feb 2015

Under the new special measures regime, the NHS Trust Development Authority and Monitor are now able to intervene at providers which the Care Quality Commission are providing poor quality care as part of their new inspection programme. This includes partnering the failing provider with a high-performing buddy, the appointment of a dedicated Improvement Director at the trust as well as other targeted interventions to ensure rapid improvements where failings have been identified.

From: Culture Change in the NHS supporting Annex (annex to Culture change in the NHS: applying the lessons of the Francis Inquiries)

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.

Site note: The Inquiry addressed this recommendation to the Care Quality Commission, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on 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 in principle by the Government.

In the January 2014 Hard Truths report, the Government said that where the Care Quality Commission issued an enforcement notice, it was the role of Monitor or the NHS Trust Development Authority to ensure that it was complied with. However, it remained the responsibility of providers’ boards to identify and resolve risks.

In the February 2015 Culture Change report, Government also referred to the new special measures regime, which it said allowed the NHS Trust Development Authority and Monitor to intervene at providers which the Care Quality Commission judged to be providing poor quality care. This included partnering the failing provider with a high-performing buddy, the appointment of a dedicated improvement director at the trust as well as other targeted interventions.

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 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. 34, PDF page 403-404.

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.