Common selection criteria
A list should be drawn up of all the qualities generally considered necessary for a good and effective leader. This in turn could inform a list of competences a leader would be expected to have.
- The NHS Leadership Competency Framework (LCF) for board members, published 28 February 2024 and effective from 1 April 2024, defines competencies across six domains: driving high-quality and sustainable outcomes; setting strategy and delivering long-term transformation; promoting equality and inclusion; providing robust governance and assurance; creating a compassionate culture; and building trusted relationships with partners and communities (NHS England, NHS Leadership Competency Framework, February 2024).
- The LCF must be incorporated into all NHS board member role descriptions, recruitment processes, and annual appraisals from 1 April 2024, establishing the list of competences a leader is expected to have as Francis recommended.
- The earlier Healthcare Leadership Model (2013) set out nine behavioural dimensions of leadership applicable at all levels, providing a predecessor competency framework. The LCF builds on this for board-level leaders specifically.
- The revised Fit and Proper Person Test framework (effective 30 September 2023) incorporates standard competencies for all board directors, reinforcing the requirement for leaders to demonstrate specific qualities and competences (NHS England, FPPT Framework, September 2023).
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
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.