F146

Finance and oversight of Local Healthwatch

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

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

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

Recommendation, verbatim from the inquiry

●Inquiry recommendation

Local authorities should be required to pass over the centrally provided funds allocated to its Local Healthwatch, while requiring the latter to account to it for its stewardship of the money. Transparent respect for the independence of Local Healthwatch should not be allowed to inhibit a responsible local authority – or Healthwatch England as appropriate – intervening.

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 the recommendation was partially implemented, reiterating that the government did not accept requiring local authorities to pass over centrally provided funds while noting that Healthwatch England publishes annual funding reports (DHSC and NHS England, Feb 2026). Previously, in May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation only in part, leaving funding allocations to local authorities while relying on annual reporting to ensure transparency (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 part.
We do not accept that local authorities should be required to pass over centrally-provided funds. We believe that local authorities are best-placed to make decisions about funding services that meet the needs of their local communities – including local Healthwatch. We expect local Healthwatch organisations to have sufficient funding to deliver against their local priorities, but we do not believe it is for the Government to dictate what this level should be.
As the Healthwatch network is new, it is not possible at this stage to specify the level of funding that is required to deliver an effective local Healthwatch function. But we do believe it is important that there is transparency about funding for local Healthwatch, and that this principle of transparency is embedded at the outset. We will therefore require each local Healthwatch to set out the amount of funding it receives in its annual report. Healthwatch England will also publish in December the amount of funding each local Healthwatch has received, and we are working with Healthwatch England to see what further steps can be taken to enable transparency.
We agree that local Healthwatch should account to its local authority, as commissioner of Healthwatch, for its use of funding provided and it is the responsibility of local authorities to ensure that appropriate arrangements are in place.
We agree that there is a balance to strike between respect for the independence of local Healthwatch organisations and the need to ensure that they are functioning effectively. Local authorities are responsible for holding their local Healthwatch provider to account. Healthwatch England already has the power to alert local authorities to concerns it may have around the performance of a local Healthwatch provider. In addition, as part of its own role in supporting local Healthwatch it has put in place measures to ensure that it has a robust overview of how the network is performing. We will work with Healthwatch England to ensure that, if needed, providers who may be struggling get the right support at the right time.

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 say partially delivered · 27 Feb 2026

As the Thirlwall Inquiry have noted, in the January 2014 Hard Truths report, the Government said it did not accept that local authorities should be required to pass over centrally provided funds, instead leaving such decisions to local authorities.

Every year Healthwatch England publish a report setting out the levels of funding each Local Healthwatch organisations has received from its Local Authority.

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 “Partially implemented - Closed”. Table row: section 18.2 No. 146, PDF page 493-494.

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

Healthwatch England has published information on local authority spend on local Healthwatch for 2013/14 and 2014/15. The Department is working with Healthwatch England to ensure ongoing transparency around funding for local Healthwatch.

Local Healthwatch are also required to include in their annual reports, which are now published every summer, the funding that they have received from their commissioning local authority.

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 local authorities, 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 part by the Government.

In the January 2014 Hard Truths report, the Government said it did not accept that local authorities should be required to pass over centrally provided funds, instead leaving such decisions to local authorities. However, the Government said it would require each local Healthwatch to set out the amount of funding it receives in its annual report, to ensure transparency. The Government accepted that local Healthwatch should account to its local authority for its use of funding.

In the February 2015 Culture Change report, the Government said that Healthwatch England had published information on local authority spend for the last two financial years, and that Local Healthwatch was required to include in their annual reports the funding they had received from their commissioning local authority.

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. 146, PDF page 460-461.

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.