On 9 January 2025, Judith Smith, Professor of Health Policy and Management at the University of Birmingham, presented expert evidence at the Thirlwall Inquiry at Liverpool Town Hall. Her contributions focused on Part C of the Inquiry, which examines the effectiveness of NHS management and governance structures in safeguarding hospitalised babies, looking at whether changes are necessary, and how accountability for senior managers can be strengthened. This section also addresses broader issues of NHS culture.
Key themes in Judith Smith's evidence
Judith Smith's evidence highlighted the following key themes:
- Well-functioning clinical governance: the necessity of having an effective system of clinical governance within NHS trusts to ensure patient safety and high-quality care.
- Corporate governance and board roles: the importance of robust corporate governance within NHS trusts, particularly the critical role of trust boards and their chairs in setting and upholding standards and accountability.
- Professionalisation of NHS management: the time is now right for further professionalisation of management across local NHS organisations and national bodies. This includes having regulation of NHS managers along with mandated and funded training and development for NHS managers and leaders.
- Cultural challenges: the longstanding NHS cultural issues which have hindered previous reforms and will likely impact the effectiveness of new recommendations, unless steps are taken to address wider NHS organisational culture.
- Actionable and accountable recommendations: the Inquiry’s recommendations (as with those of other public inquiries) will only succeed if they are designed to be practical to implement and are followed up with systematic formal scrutiny.
Access to evidence
Professor Smith’s spoken evidence is available online on the Thirlwall Inquiry website:
Additionally, her two written expert reports submitted to the Inquiry are available here:
The Thirlwall Inquiry
The report of the Thirlwall Inquiry is anticipated later in 2025. Information and updates about the inquiry are available on the Inquiry website.
