This report for the Thirlwall Inquiry, analyses questionnaires from 120 NHS trusts in April 2024. It covers various topics including governance and accountability, trust policies, staffing, culture, working relationships, reporting and managing concerns and complaints, reviewing evidence after a death, and support for bereavement. The report highlights the differences between trusts providing different levels of neonatal care and identifies overarching themes. It also discusses the regulation of senior managers, the use of trust policies, and the review of trust policies. The report includes Nuffield Trust reflections and additional references. The purpose of the report is to provide insights into the current state of NHS trusts and to inform improvements in governance, accountability, and patient care. The report draws on work on workplace-based knowledge exchange programmes between academics, policymakers and providers in the health and social care sector: