Recommendation F207: Strengthening identification of healthcare support workers and nurses
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
There should be a uniform description of healthcare support workers, with the relationship with currently registered nurses made clear by the title.
In brief (written by this site)
In commentary submitted in September 2024, the Department of Health and Social Care and NHS England stated that work was ongoing, pointing to updated workwear guidance, RCN Workforce Standards, and a national project led by NHS Supply Chain to standardise clinical uniforms, while noting that local uniform policy remains the responsibility of local organisations (DHSC and NHS England, Feb 2026). Previously, in May 2024, the Thirlwall Inquiry legal team noted that the recommendation had been accepted in principle, observing that the government had pointed to a review recommending that support workers could use the title "Nursing Assistant" upon completing fundamental care training (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 in principle.
This is a complex issue as healthcare support workers carry out a number of different tasks in varied roles, so a uniform description can be difficult. The Cavendish Review80 recommends that once healthcare assistants and healthcare support workers complete a ‘Certificate of Fundamental Care’, they should be allowed to use the title ‘Nursing Assistant’, where appropriate. The Chief Nursing Officer has agreed to lead the work around this recommendation which should be understood as part of the wider desire to develop career development to simplified job roles and core competences framework linked to the career development framework.
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)
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.
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. 207, PDF page 530.
Department of Health and Social Care says in progress (11 February 2015)
Taking account of the range of allied health professionals with whom Healthcare Assistants work, the Chief Nursing Officer is planning to release guidance in 2015 on appropriate titles for people who hold the Care Certificate. This guidance will follow the Shape of Caring review, which is being chaired by Lord Willis of Knaresborough and is due to report in in early 2015. There are no plans for any similar guidance for staff working in social care
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.
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 principle.
In the January 2014 Hard Truths report, the Government said that, as healthcare support workers carried out a number of different tasks in varied roles, a uniform description could be difficult. The Government referred to the Cavendish Review recommending that once healthcare assistants and healthcare support workers completed a ‘Certificate of Fundamental Care’ they should be allowed to use the title ‘Nursing Assistant’.
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. 207, 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