Recommendation F192: Strong nursing voice
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Department of Health and Nursing and Midwifery Council should introduce the concept of a Responsible Officer for nursing, appointed by and accountable to, the Nursing and Midwifery Council.
In brief (written by this site)
The Inquiry called for a Responsible Officer for nursing accountable to the regulatory body. In commentary of September 2024, published in February 2026, the Department of Health and Social Care (DHSC) and NHS England stated that the appointment of a Responsible Officer was not introduced, but the Nursing and Midwifery Council (NMC) established a role to confirm that revalidation requirements are met (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that the NMC had introduced its revalidation scheme without Responsible Officers in April 2016 (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 1 Oct 2026. The record below is the sources' own words.
Government response
Accepted in principle.
The aim of the recommendation, which is to have a role that is accountable for providing assurance to the Nursing and Midwifery Council that nurses are meeting professional standards and are keeping themselves up-to-date and fit to practise, is best achieved through the introduction of nursing revalidation. Unlike the General Medical Council’s model of revalidation, the Nursing and Midwifery Council does not consider that this model of revalidation requires a Responsible Officer role.
The Nursing and Midwifery Council has committed to introducing a proportionate and effective model of revalidation, which is affordable and value for money, to enhance public protection. Subject to public consultation, the proposed model would require evidence that the nurse or midwife is fit to practise. Under the current proposals, the Nursing and Midwifery Council Code and standards would be reviewed and revised to ensure they would be compatible with revalidation, and guidance for revalidation would also be developed.
NHS Employers will lead work on ensuring that there is a clear link between the values in the NHS Constitution, the vision and strategy for nursing in England, its values and behaviours as set out in the ‘6Cs’, and the organisation’s own local values. Building on this, the Department of Health will commission NHS Employers to help local organisations develop and improve value based appraisal and performance management. This will also support the actions set out in Compassion in Practice.
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 partially delivered (27 February 2026)
The appointment of Responsible Office was not introduced. The NMC has established a role who’s responsibility is to look at the evidence which the registrant has collected for revalidation and 'confirms' that the revalidation requirements have been met.
Please see response to recommendation 193 on the introduction of a revalidation system.
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 “Partially implemented – Closed”. Table row: section 18.2 No. 192, PDF page 522.
Department of Health and Social Care says in progress (11 February 2015)
In February 2013, the Nursing and Midwifery Council began a UK-wide programme of engagement on revalidation and has held two national consultations. The first ran from January to March 2014 and focused on the proposed model of revalidation The second, which ran from May to August 2014, included a draft revised Code intended to address the issues raised by the Francis reports into failings at Mid Staffordshire NHS Foundation Trust. These include, for example, putting patients first (including a greater emphasis on providing the fundamentals of care, hydration and nutrition); dealing with complaints; raising concerns (‘whistle-blowing’); the professional ‘duty of candour’; and leadership, delegation and teamworking.
The Nursing and Midwifery Council will test the resulting revalidation model in a pilot during 2015 and full implementation of the model is planned to commence by the end of 2015. The Nursing and Midwifery Council has established an oversight board that will drive forward the planning and confirm that the UK is sufficiently ready for implementation.
With Health Education England, NHS Employers has developed a mapping tool to allow local organisations to map their values to those in the NHS Constitution. NHS Employers has also produced guidance for employers linking pay progression, appraisal and performance management. This includes a number of resources to support employers including good practice case studies and a model policy. Further resources including case studies and podcasts will continue to be developed during the year.
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 principle by the Government.
The Nursing and Midwifery Council’s view was that a revalidation scheme would be more proportionately introduced without Responsible Officers. Such a scheme of revalidation was introduced in April 2016.
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. 192, PDF page 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