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F61

Consolidation of regulatory functions

Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: Department of Health and Social Care

Government responseDepartment of Health and Social Care: Not accepted (Nov 2013)

DeliveryDHSC and NHS England say not accepted (Feb 2026)Department of Health and Social Care states no delivery position (Feb 2015)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

A merger of system regulatory functions between Monitor and the Care Quality Commission should be undertaken incrementally and after thorough planning. Such a move should not be used as a justification for reduction of the resources allocated to this area of regulatory activity. It would be vital to retain the corporate memory of both organisations.

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 February 2026, the Department of Health and Social Care and NHS England reiterated that this recommendation was not accepted by the government (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government did not merge regulatory functions through the development of a single regulator (The Thirlwall Inquiry legal team, May 2024). The department had originally rejected the recommendation in November 2013, explaining that it intended to keep quality inspection separate from improvement functions rather than creating a single regulator (Department of Health response, Nov 2013).

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 · Not accepted · 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

Not accepted, although we agee with the principle regarding changes to the regulatory system.
While we do not accept this recommendation in the light of the response to recommendation 19, we agree with the principles that it outlines regarding changes to the regulatory system. If changes are required between regulatory functions, they should be considered carefully and implemented appropriately to ensure that the organisational memory is retained and that, where change is needed, it is undertaken after appropriate consultation.
However, as outlined in relation to recommendation 19, we do not intend to merge regulatory functions through the development of a single regulator. Rather we intend to implement a single failure regime with clear roles and responsibilities, keeping separate the responsibility for inspecting and assessing quality from the responsibility for improvement.

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 say not accepted · 27 Feb 2026

This recommendation was not accepted by Government.

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 “Not accepted”. Table row: section 18.2 No. 61, PDF page 456.

●Department of Health and Social Care states no delivery position · 11 Feb 2015

No further update is required. Please see response to the recommendation in Hard Truths.

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.

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 not accepted by the Government in the January 2014 Hard Truths report.

The Government did not merge regulatory functions through the development of a single regulator.

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. 61, PDF page 421.

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.