Recommendation F206: Strengthening the nursing professional voice
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The effectiveness of the newly positioned office of Chief Nursing Officer should be kept under review to ensure the maintenance of a recognised leading representative of the nursing profession as a whole, able and empowered to give independent professional advice to the Government on nursing issues of equivalent authority to that provided by the Chief Medical Officer.
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 stated that the role of Chief Nursing Officer was "now well-embedded within the national landscape", with the post holder reporting directly to the service's Chief Executive, advising the Secretary of State, and undergoing regular appraisal (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that while the government accepted the recommendation with a commitment to ongoing review, it provided no update in its February 2015 report (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 Chief Nursing Officer for England provides professional leadership for all nurses, midwives and care staff across the healthcare system. The Chief Nursing Officer is also the principal advisor to the Government on all nursing and midwifery issues with the exception of public health nursing issues. The effectiveness of the Chief Nursing Officer role will be reviewed on an on-going basis, as will the effectiveness of the Federation of Nurse Leaders, established and chaired by the Chief Nursing Officer.
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 in progress (27 February 2026)
Please see our response to recommendation 203 above for detail on the role of the Chief Nursing Officer (CNO), which is now well-embedded within the national landscape.
The CNO reports directly to Chief Executive of the NHS England and principal nursing adviser to the Secretary of State and is subject to regular appraisal. The CNO also complies with revalidation requirements that all nurses and midwives comply with through the Nursing and Midwifery Council.
There have been three CNOs for England since 2013.
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 – Ongoing”. Table row: section 18.2 No. 206, PDF page 529-530.
Department of Health and Social Care states no delivery position (11 February 2015)
No further update is required. Please see response to the recommendation in Hard Truths
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.
The tracker describes this as a long-term recommendation: systemic or cultural, with no single completion point.
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.
In the January 2014 Hard Truths report, the Government stated it would keep the effectiveness of the Chief Nursing Officer reviewed on an ongoing basis. No update was provided in the February 2015 Culture Change report.
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. 206, PDF page 492.
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