Recommendation F220: Accreditation
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
A training facility could provide the route through which an accreditation scheme could be organised. Although this might be a voluntary scheme, at least initally, the objective should be to require all leadership posts to be filled by persons who experience some shared training and obtain the relevant accreditation, enhancing the spread of the common culture and providing the basis for a regulatory regime.
In brief (written by this site)
In February 2026, DHSC and NHS England stated that implementation remained ongoing, reporting that the NHS Leadership Academy provides eight national development programmes including some accredited courses to approximately 20,000 participants annually, with wider stakeholder engagement on a leadership competency framework planned for autumn and winter 2024/25 (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team noted that the government had partially accepted the recommendation by establishing leadership development programmes while rejecting the need for a formal accreditation scheme (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.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted in part.
We think it is essential that those who fill leadership posts should be able to demonstrate that they share in the common values of the NHS and meet expected standards in respect of both leadership skills and behaviours. We do not, however, accept the need for a formal accreditation scheme.
A new suite of national leadership development programmes launched by the NHS Leadership Academy and supported by a revised healthcare leadership model will represent a consistent approach to developing leaders with the right skills and behaviours at all levels.
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 partially delivered (27 February 2026)
The NHS Leadership Academy was established in 2013 and now forms part of the Workforce, Training and Education Directorate of NHS England. A range of eight national development programmes exist for entry level to mid-level managers, including some accredited courses. These train around 20,000 participants per annum. The NHS Leadership Academy has further information on the programmes it offers for leaders.
NHS Long Term Workforce Plan
The NHS Long Term Workforce Plan (June 2023) sets out a series of interventions to train, retain and reform the workforce, and put the NHS on a sustainable footing into the future. Backed by more than £2.4 billion in government investment it outlines how the NHS will address existing vacancies and meet the challenges of a growing and ageing population by recruiting and retaining hundreds of thousands more staff over the next 15 years and reforming the way the service works. NHS England has committed to review the plan at least every two years. This has a key focus on nursing.
The Messenger Review more recently recommended consistent management standards delivered through accredited training.
Please see response to recommendation 215 for related information on the NHS Leadership Competency Framework for Board members, Fit and Proper Persons regime and Code of Practice for all leaders and managers. This is being co-designed with key health and social care stakeholders, and engagement commenced over summer 2024, supported by a national steering group. Wider stakeholder engagement is planned over autumn/winter 2024/25.
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 “Partially implemented – Ongoing”. Table row: section 18.2 No. 220, PDF page 538.
Department of Health and Social Care says in progress (11 February 2015)
The NHS Leadership Academy now delivers a single, national approach to leadership development through its wide ranging suite of programmes based around the nine ‘leadership dimensions’ of the NHS leadership framework, which good leaders at all levels in the NHS should express. These underpin the Academy’s five core leadership programmes designed to develop outstanding leaders across every tier of the healthcare system, as well as the nurse and midwife leadership programme taking forward the Prime Minister / Deputy Prime Minister commitment for 10,000 nurses and midwives to complete leadership training by March 2015. The Academy’s core programmes are accredited and, with broader take up of the NHS leadership model in the NHS, a consistent approach to identifying and developing current and future NHS leaders with the right skills and behaviours at all levels is now being applied.
The National Skills Academy for Social Care provides a range of training opportunities for aspiring and new leaders in adult social care. Although these opportunities are voluntary, there has been significant take up from the sector. In addition, the National Skills Academy for Social Care is running a ‘Leadership for Change’ training programme in conjunction with the NHS Leadership Academy, Public Health England, the Local Government Association Leadership Centre and the Virtual Staff College.
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.
Site note: The Inquiry addressed this recommendation to the NHS Leadership Academy, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on 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 in part by the Government. In the January 2014 Hard Truths report, Government rejected the need for a formal accreditation scheme. Instead, it referred to the national leadership development programmes launched by the NHS Leadership Academy.
In the February 2015 Culture Change report, the Government said that the NHS Leadership Academy’s core programmes were accredited, with a consistent approach to identifying and developing current and future NHS leaders with the right skills and behaviours.
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. 220, PDF page 498-499.
Source
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