Shared training
A leadership staff college or training system, whether centralised or regional, should be created to: provide common professional training in management and leadership to potential senior staff; promote healthcare leadership and management as a profession; administer an accreditation scheme to enhance eligibility for consideration for such roles; promote and research best leadership practice in healthcare.
- The NHS Leadership Academy, established in 2012 as part of NHS England, delivers nationally recognised leadership development programmes including the Edward Jenner Programme (foundation-level), Mary Seacole Programme (first leadership role, leading to PGCert in Healthcare Leadership), and Nye Bevan Programme (senior leaders preparing for board roles, with over 1,000 senior leaders developed) (NHS Leadership Academy, NHS England).
- The Academy functions as the leadership training system Francis envisaged, though it is not a standalone staff college in the military model he referenced. It provides common professional training, promotes healthcare leadership, and administers structured development pathways.
- NHS England published a Management and Leadership Development long-read in 2024 confirming a three-year roadmap (2024/25–2026/27) for management and leadership development, with a new Management and Leadership Framework committed to as part of the 10-Year Health Plan (NHS England, Management and Leadership Development, 2024).
- The NHS Leadership Competency Framework for board members was published on 28 February 2024, effective from 1 April 2024, defining six competency domains that must be incorporated into all NHS board member role descriptions and recruitment processes (NHS England, NHS Leadership Competency Framework, February 2024).
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.