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F70

Duty of utmost good faith

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

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

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

Recommendation, verbatim from the inquiry

●Inquiry recommendation

A duty of utmost good faith should be imposed on applicants for foundation trust status to disclose to the regulator any significant information material to the application and to ensure that any information is complete and accurate. This duty should continue throughout the application process, and thereafter in relation to the monitoring of compliance.

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

The Department of Health and Social Care and NHS England stated in commentary published in February 2026 that following the abolition of Monitor and the transfer of its functions, the policy position changed and "no more FTs are being authorised" (DHSC and NHS England, Feb 2026). Previously, the Thirlwall Inquiry legal team noted in May 2024 that the government had accepted the recommendation, requiring applicant trust leaders to confirm full disclosure and enacting an offence for false or misleading information under the Care Act 2014 (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 · 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.
NHS Trusts are expected to be open with the NHS Trust Development Authority and regulators throughout the Foundation Trust application process. In order to further support this duty of utmost good faith, the NHS Trust Development Authority will explicitly ask Trusts if they have anything to declare in relation to their application in the final Board-to-Board meeting before it is formally considered by the board of the NHS Trust Development Authority for approval to proceed to Monitor.
The Care Quality Commission is working closely with both Monitor and the NHS Trust Development Authority to ensure that all applicants are subject to inspection so that comprehensive, up-to-date information on the quality of care and governance process is available at the appropriate stages of the application process, and prior to any decision by the board of the NHS Trust Development Authority as to whether a Foundation Trust application will be supported. Monitor also now requires all applicants to sign a letter to confirm that they have provided all information relevant and material to the Foundation Trust assessment process.
The Care Quality Commission is also involving Monitor and NHS Trust Development Authority in developing its new inspection methods and surveillance model, so as to ensure that opportunities for information-sharing are identified and used fully on an on-going basis.
In addition, as set out in recommendation 173, every healthcare organisation and everyone working for them must be honest, open and truthful. This will build upon the existing requirement of Monitor’s licence that information provided is accurate, complete and not misleading and the expectation that licence-holders notify Monitor in the event of any incident, event or report that may raise concerns over compliance with their licence.

Response document: 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

The provisions for Foundation Trust (FT) authorisation remain, with the power to authorise an NHS trust as an FT vested in NHS England (provided Secretary of State has approved the authorisation and NHS England are satisfied as to the matters set out in section 35 of the NHS Act 2006), following abolition of Monitor and transfer of functions to NHS England. However, policy position has changed and no more FTs are being authorised.

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. 70, PDF page 460.

●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.

Site note: The Inquiry addressed this recommendation to Monitor, 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 by the Government.

In the January 2014 Hard Truths report, the Government said that the NHS Trust Development Authority would explicitly ask trusts if they had anything to declare in relation to their application in the final board-to-board meeting before formal consideration of approval.

The Government also said that submission for foundation trust status was required to include a letter from the Trust CEO that with regard to their duty of good faith they have disclosed all relevant information.

The Government also enacted an offence of false or misleading information at section 92 of the Care Act 2014

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. 70, PDF page 424-425.

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.