Government response Department of Health and Social Care: Accepted in part (Nov 2013)
Delivery DHSC and NHS England say partially delivered (Feb 2026) Department of Health and Social Care says in progress (Feb 2015)

Recommendation F197: Nurse leadership

From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.

Recommendation

Training and continuing professional development for nurses should include leadership training at every level from student to director. A resource for nurse leadership training should be made available for all NHS healthcare provider organisations that should be required under commissioning arrangements by those buying healthcare services to arrange such training for appropriate staff.

Jurisdiction: England

In brief (written by this site)

In commentary from September 2024 published in February 2026, the Department of Health and Social Care and NHS England reported that eight national development programmes existed for entry level to mid-level managers, including nurses, which train around 20,000 participants annually, alongside leadership programmes offered by the RCN (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that the government had accepted the recommendation in part, having recorded that training arrangements remained primarily the responsibility of providers rather than mandatory commissioning requirements (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 Department of Health and Social Care
19 Nov 2013
Speaker not recorded. Source: Department of Health, Hard Truths: the Journey to Putting Patients First, volume 2 (Cm 8777-II), November 2013

Accepted in part.
Healthcare organisations have a responsibility to ensure that their staff and teams are appropriately trained and continuously developed: having properly trained staff is one of the requirements they have to meet to register with the Care Quality Commission. The NHS Leadership Academy core programmes will provide a structured and robust leadership development education from entry level to executive level. Focused on leadership for compassionate and effective care, the programmes will provide development on the skills, knowledge, behaviours and attitudes needed at every level to create a climate for staff that puts the patient first.
Action areas under Compassion in Practice, the vision and strategy for nursing in England, include:
• new leadership programme for ward managers, team leaders and nursing directors based on values and behaviours of the ‘6Cs’ of Compassion in Practice (care, compassion, courage, communication, competence, commitment);
• providers to review options for introducing ward managers, team leaders and nursing directors based on values and behaviours of the ‘6Cs’;
• commissioning leadership role (build into Action Area 4 in Compassion in Practice); and
• contracts to address the percentage of staff who have accessed leadership development.
Arrangements for training are primarily the responsibility of providers, but when commissioners deem it is necessary, in order to ensure the delivery of services by staff with the right skills, they can set training requirements in their contracts with providers.
The Nursing and Midwifery Council published new standards for all pre-registration nursing programmes in 2010 which must be followed at all the universities they approve to run nursing courses. The previous 2004 standards were updated and strengthened as a result of the findings of the first Francis Inquiry and emerging evidence at that time. The first nurses to have followed programmes approved against these new standards will commence practice in 2014.
The Nursing and Midwifery Council will be undertaking a full evaluation of these new education standards, commencing in 2014, and will have particular regard to the issues of caring and compassion. This will give a proper evidence base for any further revisions to these new standards, and the Nursing and Midwifery Council will consider this recommendation in parallel with their evaluation.
Although the overarching national standards are in place, the detail of the nursing curriculum is dynamic. Employers, service providers and universities are now brought together in Local Education and Training Boards, as part of the Health Education England system, to ensure all NHS funded courses are fit for purpose and reflect service needs. We expect this new part of the system to recognise the importance of Compassion in Practice and the values and behaviours it describes in the ‘6Cs’, to be part of the local review of courses and incorporated into the detailed undergraduate nursing curriculum. The Department of Health will commission NHS Employers to encourage NHS organisations to strengthen their local knowledge and skills frameworks so that there is a clear line of sight between the NHS Constitution, the values and behaviours set out in the 6Cs of Compassion in Practice, the vision and strategy for nursing in England, and local values, performance and appraisal systems.
Health Education England and the Nursing and Midwifery Council will continue to collaborate on ensuring the undergraduate nursing curriculum meets patient need.

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)

A range of eight national development programmes exist for entry level to mid-level managers, including nurses. These train around 20,000 participants per annum. Further information on programmes offered via the NHS Leadership Academy is on their website.

The RCN also offers a leadership programme

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

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 - Ongoing”. Table row: section 18.2 No. 197, PDF page 525.

Department of Health and Social Care says in progress (11 February 2015)

The Nursing and Midwifery Council has commenced the evaluation of their standards for pre-registration education for nurses and midwives. Central to the evaluation are questions about the effectiveness of standards in preparing nurses and midwives for their professional roles and responsibilities which include care, compassion and leadership.

The Nursing and Midwifery Council has appointed IFF Research to undertake the independent evaluation of pre-registration education for nurses and midwives. They are expected to submit their interim report to the Nursing and Midwifery Council in February 2015 at which point the findings will be shared with Health Education England. The Nursing and Midwifery Council’s final report should be available by September 2015.

The outcomes of the evaluation will provide an evidence base for future reviews of their pre-registration standards for education so that they can, where necessary, enhance the UK standards for nurse and midwifery competence and education.

From: Culture Change in the NHS supporting Annex (annex to Culture change in the NHS: applying the lessons of the Francis Inquiries)

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 NHS, 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 NHS Leadership Academy core programmes would provide a structured and robust leadership development education from entry-level to executive-level.

The Government stated that arrangements for training were primarily the responsibility of providers, but when commissioners deemed it necessary, they could set training requirements in their contracts with providers.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024)

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. 197, PDF page 488.

Source

Report Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry 06 Feb 2013

Responsible bodies

NHS Primary

Who has spoken

  • Department of Health and Social Care
    Response, delivery statement
  • DHSC and NHS England
    Delivery statement
  • Thirlwall Inquiry legal team
    Finding
Recommendation made 13.7 years ago