The Hillsborough Bill in Healthcare: challenge, change and opportunity

The Hillsborough Bill is set to redefine inquests. Increased family representation, a new statutory duty of candour and greater expectations of transparency will bring heightened scrutiny of healthcare providers. Our latest briefing explores what these landmark reforms mean in practice.

The passage of the Public Office (Accountability) Bill (better known as the "Hillsborough Bill") represents one of the most significant developments in the inquest and inquiries landscape in a generation. The legislation introduces a statutory duty of candour for public bodies, strengthens accountability across public authorities and expands access to publicly funded representation for bereaved families.

Much of the commentary has focused on the additional obligations placed on public bodies. For healthcare providers, however, the picture is more nuanced. Whilst NHS Trusts and other healthcare organisations are likely to face increased scrutiny, many are already operating within frameworks built around candour, transparency and organisational learning. 

The key reforms

The legislation introduces three reforms of particular significance to healthcare inquests:

• A statutory duty of candour and assistance applying across public authorities.
• Measures designed to create greater parity of arms between families and public bodies; and
• Non-means-tested legal aid for bereaved families participating in inquests. 

Legal aid

Non-means-tested legal aid will be available where a bereaved family is participating in an inquest in which a public authority is an Interested Person. The aim is to address the perceived imbalance that can arise when families engage in proceedings involving public bodies without equivalent legal representation of their own.

The rationale for the changes is clear. For many years, campaigners argued that bereaved families often found themselves facing multiple publicly funded legal teams without equivalent representation of their own. The Government has described the reforms as the largest expansion of legal aid for bereaved families in more than a decade.

Whilst the legislation stems from the Hillsborough disaster and the response that followed, its practical impact is likely to be felt most keenly in everyday coronial proceedings involving healthcare providers. Around 36,000 inquests were opened in 2025 in England and Wales¹ , and public authorities (including NHS Trusts) feature as Interested Persons in a significant proportion of those investigations.

Who does the Hillsborough Bill apply to?

Although much of the discussion surrounding the Hillsborough Bill has focused on police, government bodies and NHS Trusts, its potential reach may be considerably wider. The Bill also extends to bodies exercising functions of a public nature and, in some circumstances, those acting on behalf of public authorities.

This creates an important area of uncertainty for independent healthcare providers delivering NHS-funded services, GP practices, social care providers and care homes. Until greater clarity emerges, these organisations may wish to proceed on the assumption that the legislation could apply to them and ensure that their investigation, disclosure and governance processes reflect the same standards of transparency and candour expected of public authorities. 

Beyond disclosure: the new Duty of Candour

Perhaps the greatest impact of the Hillsborough Bill will be cultural. At its heart, the legislation seeks to shift the focus of public authorities away from perceived institutional self-protection and towards transparency and accountability. For healthcare providers, many of these principles that will already be familiar through the existing Duty of Candour regime and patient safety frameworks. What remains less clear is how the new statutory duty will interact with the existing healthcare-specific duty of candour regime and whether it will impose additional obligations beyond those which providers are already required to meet.

Coroners and families may increasingly expect to see evidence of early engagement, timely disclosure, frank acknowledgement of issues where they exist, and a clear commitment to organisational learning. A technically compliant approach may no longer be sufficient if the overall impression is that the organisation has been defensive, reactive or reluctant to assist. 

NHS organisations that can demonstrate early disclosure, meaningful engagement with families and a genuine commitment to learning are likely to be better positioned under the new regime. The Hillsborough Bill therefore reinforces an increasingly important principle: public confidence will depend not only on the quality of care provided, but also on how an organisation responds when things go wrong.

Parity of arms: more representation, more balance 

A common assumption is that increased family representation will inevitably lead to longer and more adversarial inquests. The reality is more nuanced and remains to be seen in practice. Experienced practitioners will recognise that unrepresented families often require greater intervention from Coroners to ensure relevant issues are properly explored. Professionally represented families can assist the court by identifying key issues early, narrowing disputes and presenting focused submissions.

Whilst some healthcare inquests are likely to become more robust, increased representation may also result in earlier identification of issues, more focused questioning and more effective case management. The result may be not simply greater scrutiny, but a more balanced and efficient inquisitorial process.

Article 2 and Legal Aid: A changing dynamic

One of the least discussed consequences of the Hillsborough Bill may be its impact on Article 2 arguments within the coronial jurisdiction. Historically, applications for Exceptional Case Funding have often become intertwined with disputes over whether Article 2 of the European Convention on Human Rights is engaged. 

The Hillsborough Bill has the potential to alter that dynamic fundamentally. If bereaved families can obtain publicly funded representation without establishing Article 2 engagement, one of the principal practical drivers behind many Article 2 submissions may disappear. That does not change the legal test for Article 2 engagement, which will continue to determine the scope of the investigation and level of scrutiny applied by the Coroner. It may, however, reduce the extent to which funding considerations drive arguments about engagement.

The evolving role of healthcare lawyers

The Bill introduces obligations relating to the conduct of public authorities and their representatives at inquests, together with an expectation that expenditure on legal representation should be necessary and proportionate. 

For healthcare providers, this is unlikely to mean dispensing with legal representation. The complexity of many healthcare inquests, particularly those involving Article 2 issues, complex clinical causation or those before a jury, continues to justify specialist legal support. Staff support is likely to be a key concern. However, the role of lawyers may increasingly be scrutinised through the lens of candour and proportionality. Rather than being viewed solely as advocates for their client's position, they may be expected to assist in ensuring appropriate disclosure, identifying the relevant issues in dispute and facilitating the efficient conduct of proceedings. Whilst many representatives will already be doing this, in practice, healthcare organisations may therefore need to place greater emphasis on demonstrating how legal representation assists the inquisitorial purpose of the inquest. 

Will the House of Lords approve it?

As matters currently stand, the political momentum behind the legislation appears considerable. The Bill has already passed through the Commons following extensive debate and amendment. The recent arrival of Andy Burnham as Prime Minister will only strengthen that momentum. Burnham's political association with the Hillsborough families is longstanding; indeed, his involvement with the Hillsborough Independent Panel was one of the defining episodes of his ministerial career.

Given the broad cross-party support that the Bill has generally received and the symbolic significance attached to the legislation, opposition in the House of Lords is more likely to focus on refining specific provisions than on defeating the Bill outright. Whilst amendments remain possible, the direction of travel appears clear – the Bill will be approved. 

Conclusion: challenge, change and opportunity

The Hillsborough Bill will undoubtedly reshape healthcare inquests. More families will be represented, expectations of transparency will increase, and greater scrutiny will be applied to organisational decision-making. However, the legislation should not be viewed solely through the lens of increased risk.  The most significant legacy of the Hillsborough Bill may be better-informed investigations, earlier engagement with families and a stronger focus on learning following a death. For many healthcare organisations, the challenge will not be adapting to entirely new principles, but demonstrating that openness, candour and accountability are already embedded in the way they operate.

¹ Coroners statistics 2025: England and Wales - GOV.UK