Recommendation F6: Clarity of values and principles
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The handbook to the NHS Constitution should be revised to include a much more prominent reference to the NHS values and their significance.
In brief (written by this site)
The Department of Health and Social Care and NHS England reported in February 2026 that the recommendation was implemented, stating that the handbook to the NHS Constitution in England was updated in October 2023 to give prominent focus to NHS values and their significance (DHSC and NHS England, Feb 2026). Earlier, the Thirlwall Inquiry legal team noted in May 2024 that revised handbooks published in March 2013 and July 2015 set out and explained the values in their first substantive section (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
Government response
Accepted.
The Department of Health has already taken action to reflect this recommendation in the Handbook to the NHS Constitution.
As noted in the response to recommendation 4, the NHS Constitution sets out the following values for the NHS:
Working together for patients
• Respect and dignity
• Commitment to quality of care
• Compassion
• Improving lives
• Everyone counts
The Constitution provides more information about these values, and the Department included an explanation of these values in the handbook when it was updated in March 2013.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say completed (27 February 2026)
The Handbook to the NHS Constitution in England was last updated in October 2023 and gives prominent focus to the NHS values and their significance.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Closed”. Table row: section 18.2 No. 6, PDF page 426.
Department of Health and Social Care says in progress (11 February 2015)
Sir Robert Francis QC was clear in his Inquiry report that the principal message of the NHS Constitution should be that patients and their safety come first. In Hard Truths, the Department of Health committed to strengthening the NHS Constitution to make this clearer for patients, staff and the public. To this end, The Government has launched a consultation into, amongst other things, refreshing the NHS Constitution to reflect the recommendations made by Sir Robert Francis QC. The key elements are:
• duty of candour;
• safe care and avoidable harm;
• staff guidance, and;
• a patient-centred NHS.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government. A revised handbook was published in March 2013 and again in July 2015. The first substantive section sets out and explains the NHS values.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 6, PDF page 386-387.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding