Fifty Years of Inquiries in the NHS

‘I felt a great gulp in my throat when I started because I think I really do care about this, I do feel righteous and indignant about it, and I launched it out and read it and within 30 seconds I knew I had gripped the House’ (Richard Crossman).

Professor Judith Smith
Professor Martin Powell

On 27 March 1969, Secretary of State for Social Services, Richard Crossman, made a statement to the House of Commons on the ‘Report of the Committee of Inquiry into the Ely Hospital, Cardiff’ (chaired by QC, and future Conservative Chancellor, Geoffrey Howe) which had been set up in 1967 to investigate allegations of ill-treatment of patients and of pilfering by staff which had been made by a nursing assistant employed at the hospital.  

There have been a large number of NHS inquiries over the last fifty years, sometimes known by names that still have great resonance within the health service and wider public such as Bristol, Shipman, and Mid Staffs.

The 50th anniversary of inquiries in the NHS presents an important opportunity to ask some tough questions about their purpose, value and outcomes. Such questions include:  how far do the NHS, policy makers, politicians and others really care about the material contained within inquiry reports, and how serious is their stated commitment to act upon them? Furthermore, do inquiry reports actually enable the NHS to undertake proper and profound learning, and make significant steps towards trying to ensure that events do not repeat themselves?

This joint University of Birmingham, University of Manchester and Health Foundation project introduces material arising from an event hosted by The Health Foundation in November 2018 which focused on NHS inquiries in the fifty years following the Ely Report, which is generally considered to be the first modern NHS Inquiry.  Download a summary of the discussions at the symposium.  

At the symposium, presentations were made of some of the ideas to be published in a set of academic papers in a Special Edition of Political Quarterly in summer 2019, focusing on individual inquiries, and comparing issues such as culture, recommendations, and the role of the public across Inquiries.

Health Foundation Conference


A viewpoint on the website by Martin Powell and Kieran Walshe addresses a number of important issues such as the purposes of inquiries and what has been learned from them.

Mid Staffordshire NHS Foundation Trust Public Inquiry overview

Peer Reviewed Articles


Carlyle, R. (2019) Public Involvement in NHS Inquiries, The Political Quarterly: 90 ( 2) April–June 2019

Chambers, N., Boyd, A., Kendrick, H., Proudlove, N., Thorlby, R., Smith. J. and Mannion, R. (2016) Board leadership in the wake of Francis: challenges, changes and achievements. Health Service Journal, 10 June 2016

Davies, H.T.O. & Mannion, R. (2013) Will prescriptions for cultural change improve the NHS? British Medical Journal,  346: f1305

Goodwin, D (2019) NHS Inquiries and the Problem of Culture, The Political Quarterly: April–June 2019

Hilton, C. (2019) A Tale of Two Inquiries: Sans Everything and Ely, The Political Quarterly: 90 (2) April–June 2019

Mannion R Davies H, Powell M, Blenkinsopp J Millar R McHale J Snowden N (2019) Healthcare scandals and the failings of doctors: do official inquiries hold the profession to account? Journal of Health Organisation and Management.

Mannion R and Davies H (2018) Understanding organisational culture for healthcare quality improvement, BMJ: 363:k4907 

Mannion R and Smith JA (2017) Hospital culture and clinical performance: where next? BMJ Quality and Safety Published Online First: 20 December 2017. 

Powell, M. (2019) Learning from NHS Inquiries: Comparing the Recommendations of the Ely, Bristol and Mid Staffordshire Inquiries, The Political Quarterly: April–June 2019

Powell, M. (2019), Inquiries in the British National Health Service, The Political Quarterly: April–June 2019

Ryan, S (2019) NHS Inquiries and Investigations; an Exemplar in Peculiarity and Assumption, The Political Quarterly: 90 (2) April–June 2019

Smith, J and Chamers N (2019) Mid Staffordshire: a Case Study of Failed Governance and Leadership? The Political Quarterly: 90 (2) April–June 2019

Smith JA (2014) Hospital culture has changed due to Francis.  Health Service Journal, 6 February 2014, p xx

Smith JA (2013) The Francis Inquiry: from diagnosis to treatment.  Journal of Medical Ethics. Published Online: 12 December 2012 

Timmins, N. (2019) An Elementary Primer for Politicians and Potential Chairs on Public Inquiries, The Political Quarterly: 90 (2) April–June 2019

Walshe, K (2019) Public Inquiry Methods, Processes and Outputs: an Epistemological Critique, The Political Quarterly: 90 (2) April-June 2019


Snappy Search

A round up of resources on the Francis Inquiry produced by the HSMC Library.