The government has rejected nine of Robert Francis’ 290 recommendations.

They concern the merging of the Care Quality Commission and Monitor;  the powers of commissioners; Healthwatch;  the individual duty of candour; and the regulation of healthcare assistants.

The rejected recommendations are:

Recommendations 19, 61 and 64 – Merger of system regulatory functions. The response says: “We do not intend to merge regulatory functions [of the Care Quality Commission and Monitor] through the development of a single regulator. Rather we intend to implement a single failure regime with clear roles and responsibilities.”

Recommendation 137 – Commissioners’ powers of intervention. The response says: “To give regulators and commissioners equivalent powers of intervention would blur the distinction of … roles and risk causing confusion in the system, resulting in inaction because of assumptions that another body is intervening to address a problem.”

Recommendation 145 – Local Healthwatch structure. The response says: “We believe that local Healthwatch organisations should be set up in a way that best meets the needs and reflects the circumstances of their local communities; taking a top-down approach and imposing a fixed structure would undermine the need for flexibility.”

Recommendation 183 – Criminal offence to obstruct statutory duties. The response says: “The government does not intend to criminalise untruthful statements to commissioners and regulators made by healthcare professionals.”

Recommendation 209 – Registration for healthcare support workers. The response says: “There is no solid evidence that demonstrates that healthcare and care support workers should be subject to compulsory statutory regulation, given the safeguards that are already in the system.”

Recommendation 212 – Developing standards for healthcare support workers. The response says: “This recommendation is a step toward regulation (see recommendation 209) and for the same reasons, we are rejecting this recommendation.”

Recommendation 213 – Dismissing unsatisfactory staff following breach of code of conduct. The response says: “We do not believe that regulation of health care assistants and support workers will improve the quality of care.”