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F73

Need for constructive working with other parts of the system

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: Accepted (Nov 2013)

DeliveryDHSC and NHS England say in progress (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

The Department of Health's regular performance reviews of Monitor (and the Care Quality Commission) should include an examination of its relationship with the Department of Health and whether the appropriate degree of clarity of understanding of the scope of their respective responsibilities has been maintained.

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 reported that Monitor had become part of NHS England, regular accountability meetings were held under a framework agreement, and recommendations to enhance oversight of the Care Quality Commission had been acted on (DHSC and NHS England, Feb 2026). Previously, in May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation and used standard accountability processes to keep relationships with arm's length bodies under regular review (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.
As part of the normal accountability processes that the Department of Health has set in place as a sponsor, the state of the relationship between the Department and its arm’s length bodies is kept under regular review. Discussions include key areas of risk, consideration of how well the Department and the relevant arm’s length body are working together and what could be done to improve co-operation and shared understanding. These discussions also include consideration of how the arm’s length body is working within the wider health and care system, including areas of significant uncertainty or concern in relation to other arm’s length bodies.

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 in progress · 27 Feb 2026

Monitor merged with NHS Improvement which now forms part of NHS England.

The DHSC’s have a non-binding framework agreement which details how each organisation intends to work with the other. As part of these working arrangements DHSC expect to have quarterly accountability meetings with half yearly meetings chaired by ministers and other meetings chaired by the Senior Departmental Sponsor (SDS) with CQC and expect such meeting to be attended by the CQC Chief Executive.

Dr Penny Dash’s review into CQC’s operational effectiveness, and her recommendations in the interim report, published in July, stated that DHSC should enhance its oversight of CQC in line with the Cabinet Office’s Sponsorship Code of Good Practice. In particular, more regular performance review conversations should take place between DHSC and CQC to reinforce and check progress against the recommendations in this report. Meetings should include senior civil servants at DHSC, ideally the relevant directors general, and should take place on a monthly basis. The recommendation has been acted on.

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 – Ongoing”. Table row: section 18.2 No. 73, PDF page 461.

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

The normal accountability processes that the Department of Health has set in place as a sponsor continue to address this recommendation.

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 accepted by the Government.

In the January 2014 Hard Truths report, the Government said that as part of the Department of Health’s normal accountability processes, the state of the relationship between it and its arm’s length bodies was kept under regular review, which included consideration of how well they were working together and what could be done to improve coordination. to normal accountability processes that the Department of Health set in place as keeping relationship between the Department of Health and its arm’s length bodies under regular review.

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. 73, PDF page 426.

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.