The role and impact of recommendations from NHS inquiries: a critical discourse analysis

A National Health Service Inquiry is set up after an adverse event in order to ascertain the facts, learn from them and so prevent similar events happening in the future. However, several researchers have suggested that they are more complex social performances whose complexity renders them relatively ineffective in bringing about change.
The current study tested this interpretation by an analysis of the formal Recommendations from the 14 large scale NHS Inquiries which took place in the period from 1967 to 2014. Their content was critically analysed for divergent themes, and similarities and differences between Inquiries were considered by reference to the historical circumstances of their production. Some support was found for the interpretation of Inquiries as complex symbolic events.
In contrast to their apparent function as simple instruments to drive change, Inquiry Recommendations can be shown to be produced in the service of divergent ends. These may create tensions in the final text which will impede the implementation of changes. To avoid this outcome, consideration of the ways and means of implementing change needs to be included in the Inquiry process.