Which organisations actually say no: a league table, not a vibe

3 September 2026

Reputation for openness and actual measured behaviour aren't always the same thing. Now that enough releases have real archived text behind them, we can rank health bodies directly - not by how much they publish, but by how often what they publish turns out to be a refusal, an exemption, or "we don't hold that."

The ranking

Organisation Releases read Refusal / exemption rate
Public Health England 36 52.8%
Monitor 261 32.6%
Medicines and Healthcare products Regulatory Agency 157 32.5%
Department of Health and Social Care 38 21.1%

Public Health England's rate is the highest here, though on a modest sample (36 releases) that we'd treat as suggestive rather than settled. Monitor and the MHRA land within a rounding error of each other despite very different roles - one a financial regulator for NHS providers, the other a medicines and devices regulator - which at least suggests refusal rate here isn't purely a function of subject sensitivity.

Publishing often isn't the same as answering fast

The MHRA is the organisation we've written about before for its unusually disciplined weekly publishing rhythm - a release every week, like clockwork. That discipline doesn't carry over to speed: among the bodies we have enough dated releases to measure, the MHRA has the slowest median response time of any of them, at 159 working days. Monitor, by contrast, is the fastest at 21 working days - close to the statutory limit rather than eight times over it.

Organisation Median response Dated releases measured
Monitor 21 working days 188
Department of Health and Social Care 25 working days 7
Public Health England 80 working days 16
Medicines and Healthcare products Regulatory Agency 159 working days 19

Publishing weekly evidently describes the MHRA's release cadence, not how quickly any individual request gets answered - the two are easy to conflate and turn out to be unrelated here.

Reading this responsibly

This ranks health bodies with real archived text - GOV.UK releases specifically, since we don't yet pull full text from WhatDoTheyKnow (see our about page for why), which is where most individual NHS trust activity lives. That means this table reflects national regulators and arm's-length bodies more than frontline trusts - see our piece on why most trusts aren't in this dataset at all for that gap. We also excluded a couple of organisations that our automated classifier occasionally mis-assigns to this niche despite having nothing to do with health (a Civil Nuclear Constabulary release about a nuclear site occasionally gets tagged health-adjacent by keyword overlap) rather than publish a misleading number. "Refusal or exemption rate" is a text-presence signal, not a legal audit - a document can mention an exemption while explaining it doesn't apply.