Fundamental standards of behaviour

Accepted in principle.
We support the principle of making clear which codes staff are expected to follow. However, as the NHS Constitution is intended to be a succinct and enduring document, the details of codes are more appropriately set out in the Handbook to the NHS Constitution rather than the Constitution.
The Constitution already includes a duty for staff ‘to accept professional accountability and maintain the standards of professional practice as set by the appropriate regulatory body applicable to your profession or role’. The handbook, which provides more detailed guidance on each of the rights, pledges and responsibilities included in the Constitution, sets out the relevant professional bodies but does not currently reference the relevant codes of these bodies nor any managerial codes.
When the Constitution is next updated, the Department of Health will consider how best to reflect in the Handbook the codes of conduct including the relevant professional and managerial codes, by which NHS staff are bound at that time.

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.

Sir Robert Francis QC was clear in his Inquiry report that the principal message of the NHS Constitution should be that patients and their safety come first. In Hard Truths, the Department of Health committed to strengthening the NHS Constitution to make this clearer for patients, staff and the public. To this end, The Government has launched a consultation into, amongst other things, refreshing the NHS Constitution to reflect the recommendations made by Sir Robert Francis QC. These are:
• duty of candour;
• safe care and avoidable harm;
• staff guidance, and;
• a patient-centred NHS.

This recommendation was accepted by the Government in principle.

The NHS Constitution includes a general requirement for staff to aim to follow all guidance, standards and codes relevant to one’s role. The Handbook gives examples of where those codes can be found but does not include express reference to them. The Government response explained this was because the NHS Constitution was intended to be a succinct and enduring document.