Code of conduct for healthcare support workers
There should be a national code of conduct for healthcare support workers.
- The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England was published on 26 March 2013 by Skills for Care and Skills for Health, as part of the government's initial response "Patients First and Foremost" (Code of Conduct and National Minimum Training Standards Published, DHSC, 26 March 2013).
- The Code sets behavioural standards for healthcare support workers with patient-facing roles, covering areas including accountability, promoting and upholding privacy and dignity, working cooperatively, communicating effectively, respecting people's right to confidentiality, and maintaining clear professional boundaries.
- The Code remains in effect and is used alongside the Care Certificate (launched April 2015) as the framework for HCA professional conduct. CQC may reference the Code when inspecting providers, though compliance at the individual worker level is voluntary in the absence of statutory registration.
- The Cavendish Review (July 2013) endorsed the Code of Conduct approach and recommended that it be embedded into training through the proposed Certificate of Fundamental Care, which became the Care Certificate (Review of Healthcare Assistants and Support Workers in NHS and Social Care, Camilla Cavendish, July 2013).
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe 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
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.
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.
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.