Recommendation R1: Sickness-absence record for entrants to nursing
From The Allitt Inquiry Report, published 11 February 1994.
Recommendation
We recommend that for all those seeking entry to the nursing profession, in addition to routine references the most recent employer or place of study should be asked to provide at least a record of time taken off on grounds of sickness (para 2.4.4)
Government response
Recommendation 1. We recommended that, for all those seeking entry to the nursing profession, in addition to routine references the most recent employer or place of study should be asked to provide at leas: a record of time taken off on grounds of sickness. From April 1995, there will be consistent and agreed guidelines on seeking references from the most recent employer or place of study on a record of time taken off on grounds of sickness. The English National Board for Nursing, Midwifery and Health Visiting (ENB) has issued draft regulations and guidelines which will meet this recommendation. Additionally, the University and Colleges Admission Service has agreed to harmonise their arrangements with those of the ENB.
Delivery
DHSC and NHS England state no delivery position (27 February 2026)
This update applies to recommendation 1, 4, 5, 6, 7, 8 and 9.
The Thirlwall Inquiry has noted immediate action agreed following the conclusion of the Allitt Inquiry. Since then, this recommendation has been superseded by the following:
• Legislative change, in particular the introduction of the Equality Act 2010 and the Data Protection Act 2018 (UK General Data Protection Regulation; and
• Guidance from NHS Employers on Employment Standards, which sets out requirements that must be carried out for all workers before commencing any type of work in the NHS, including work health assessments, employment history and reference checks, and criminal record checks.
In addition, in the case of nurse, midwives and nursing associates, the Nursing and Midwifery Council sets the professional standards that nurses, midwives and nursing associates must uphold in order to be registered to practise in the UK. These standards supersede those that were in place at the time. Equivalent standards apply to others in professionally regulated roles.
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 “Superseded”. Table row: section 3.2 No. 1, PDF page 14.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
In November 1994, the Secretary of State for Health said that, from April 1995, there would be consistent and agreed guidelines on seeking references from the most recent employer or place of study on a record of time taken off on ground of sickness. The Secretary of State said that the English National Board for Nursing, Midwifery and Health Visiting had issued draft regulations and guidelines which would meet this recommendation, and that the University and Colleges Admission Service had agreed to harmonise its recommendations accordingly.
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 3.2 No. 1, PDF page 14.
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding