Recommendation F190: National standards
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
There should be national training standards for qualification as a registered nurse to ensure that newly qualified nurses are competent to deliver a consistent standard of the fundamental aspects of compassionate care.
In brief (written by this site)
In February 2026, the Department of Health and Social Care and NHS England reported that implementation was complete, explaining that the Nursing and Midwifery Council undertakes education quality assurance to ensure programmes meet required standards, alongside wider reviews of undergraduate nursing degrees (DHSC and NHS England, Feb 2026). Previously, the Thirlwall Inquiry legal team found in May 2024 that while local preceptorship standards had been developed, it was "unclear what further was done" to ensure newly qualified nurses were competent at the point of registration (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.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted in part.
The Nursing and Midwifery Council already sets national standards for undergraduate degrees, but Health Education England and NHS England, in collaboration with the Nursing and Midwifery Council and the universities, will work closely together to ensure newly qualified nurses are competent at the point of registration.
This collaboration is vital because the competence of nursing students is assessed not only in the classroom by the universities, but in clinical practice by mentors and assessors who are experienced, practising NHS nurses. NHS England should ensure that Compassion in Practice, the vision and strategy for nursing in England, and its behaviours and values expressed as the ‘6Cs’, are used to assess student nurses during their clinical placements. The importance of robust mentoring and assessing of student nurses will be endorsed by NHS England so that only student nurses who are competent pass their assessments and are consequently recommended for registration. The Nursing and Midwifery Council has put a system of ‘sign off mentors’ in place so that experienced NHS nurses sign off student nurses achievements in clinical practice, and NHS England needs to ensure that mentors are sufficiently supported to make difficult decisions and confidently fail a student if necessary.
Competence at the point of registration needs to be enhanced in the first months of qualification by Health Education England, NHS England and employers giving appropriate support to newly qualified nurses. The established mechanism for this is through preceptorship, but Health Education England and NHS England will need to assure themselves that preceptorship programmes are systematically embedded and properly supported so that newly qualified nurses can grow in competence and confidence and effectively make the transition from being a student to a professional, practising registered nurse.
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 Nursing and Midwifery Council (NMC) undertake Education quality assurance (EdQA) to make sure that the education programmes for nurses, midwives and nursing associates meet the standards needed to prepare them to join their register.
Please see response to recommendation 152 for information on NHS England’s Education Quality Framework programme.
The NHS Long Term workforce plan sets out NHS work with regulators, education providers and students to review the structure of undergraduate degree programmes.
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. 190, PDF page 521.
Department of Health and Social Care says in progress (11 February 2015)
To provide support to preceptorship, some Health Education England Local Education and Training Boards have developed Preceptorship Standards with their stakeholders to enable service providers to have a better understanding of what good preceptorship entails.
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.
Site note: The Inquiry addressed this recommendation to the Nursing and Midwifery Council, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on 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 in part by the Government.
In the January 2014 Hard Truths report, the Government said that the Nursing and Midwifery Council had already set standards for undergraduate degrees, but Health Education England, NHS England and the Nursing and Midwifery Council would work together to ensure newly qualified nurses were competent at the point of registration. Unclear what further was done.
In the February 2015 Culture Change report, the Government said that Health Education England local education and training boards had developed preceptorship standards with their stakeholders.
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. 190, PDF page 484-485.
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