Strengthening identification of healthcare support workers and nurses
There should be a uniform description of healthcare support workers, with the relationship with currently registered nurses made clear by the title.
- NHS Supply Chain is leading the NHS National Healthcare Uniform project to introduce a nationally standardised approach to uniforms for clinical roles, including nursing and allied health professions (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- NHS England published updated guidance for NHS Employers on Uniforms and workwear in April 2023, which provides examples of good practice but is not profession-specific (Uniforms and workwear: guidance for NHS employers, NHS England, April 2023).
- The Care Certificate was launched on 1 April 2015 as a standardised induction training for healthcare assistants and social care support workers (Care Certificate, Health Education England, April 2015).
How was this evidence gathered?
Response
Accepted in Part
Response
Accepted in PartThe government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf
Progress Timeline
DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Implemented – Ongoing. The RCN Workforce Standards are designed to support a safe and effective nursing workforce alongside each nation's legislation and set out information on key roles. The development of local uniform policy is the responsibility of local organisations. NHS Supply Chain is leading the NHS National Healthcare Uniform project to introduce a nationally standardised approach to uniforms, which will considerably simplify the process; introducing a standardised, high quality, innovative uniform developed in collaboration with health care professionals. The scope of this project covers professionals working within clinical roles, equating to approximately 600,000 wearers, including Allied Health Professions, Healthcare Sciences, Midwifery, Nursing and Pharmacy. NHS England additionally publishes guidance for NHS Employers on Uniforms and workwear (2023). This supports the specific requirements of the Health and Social Care Act 2008 Code of Practice relating to uniform and workwear policies, and the need to ensure that they support effective hand hygiene. The revised guidance offers some new and updated examples of good and poor practice of uniform and work wear. It is not profession specific.
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.
NMC Revalidation launched 1 April 2016 in direct response to Francis Report. All nurses and midwives must revalidate every three years. Replaced the Post-Registration Education and Practice system. Updated NMC Code published March 2015 strengthened requirements around candour and raising concerns.
Care Certificate launched 1 April 2015 as standardised induction training for all new healthcare assistants and social care support workers. Covers 15 standards (updated to 16). Implements recommendations from Cavendish Review (July 2013) and Francis Report on healthcare support worker training.
NMC published updated Code of Professional Standards for nurses and midwives (March 2015). Standard 14 specifically requires nurses and midwives to be open and candid with all service users about all aspects of care, including when mistakes or harm have occurred.
Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.
Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.