Fundamental standards of behaviour

Source — verbatim from the inquiry

Published evidence summary

Response — verbatim from government

Evidence trail — what's actually happened since

• 1 Apr 2025 DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Implemented – Closed. Under Staff responsibilities, the NHS Constitution (as last updated in August 2023) requires that staff have a duty to accept professional accountability and maintain the standards of professional practice as set by the appropriate regulatory body applicable to their profession or role. Reference is made to the relevant standards of professional practice rather than the codes. The NHS Standards of Business Conduct Policy, published in April 2013 (and updated in April 2024), sets the standards of conduct and integrity expected from Board members, employees and all that work in the NHS. The NHS Leadership Competency Framework for Board members was first published in February 2004, and most recently updated in February 2024. It has been designed around six competency domains to support the recently refreshed Fit and Proper Persons regime. This sets out domains aligned to the NHS values described in the NHS Constitution. The competency domains are aligned to Our NHS People Promise, Our Leadership Way and the Seven Principles of Public Life/Nolan Principles. Additionally, a management code and standards – supported by an accredited development pathway covering the management of people, operations (including data and analytics), finance and self – is in development for all NHS managers. Source →
• 6 Feb 2023 · Academic Review - Ten Years After Francis 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. View source → Reasonable Progress
• 27 Jul 2015 · UK Government - NHS Constitution Updates NHS Constitution was updated in July 2015, incorporating duty of candour expectations and strengthened staff/patient rights. Constitution is reviewed every 10 years (most recent review 2023). Handbook revised to include more prominent reference to professional codes. View source → Confirmed Completed
• 11 Feb 2015 · UK Government - Culture Change in the NHS 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. View source → Good Progress
• 19 Nov 2013 · UK Government - Hard Truths Vol 1 & 2 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. View source → Good Progress

Each entry above links to a primary source — gov.uk written statement, consultation response document, or inspection report. The Index does not characterise government intent; it tracks what has been published.