Nurse leadership
Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: Department of Health and Social Care
Government responseDepartment of Health and Social Care: Accepted (Nov 2013)
DeliveryDHSC and NHS England state no delivery position (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)
Recommendation, verbatim from the inquiry
●Inquiry recommendation
The Knowledge and Skills Framework should be reviewed with a view to giving explicit recognition to nurses' demonstrations of commitment to patient care and, in particular, to the priority to be accorded to dignity and respect, and their acquisition of leadership skills.
Mid Staffs Inquiry, Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · 6 Feb 2013 Source PDF →
Published evidence summary
AI-generated evidence summary
In commentary provided in September 2024, the Department of Health and Social Care and NHS England stated that the recommendation had been superseded, noting that the Knowledge and Skills Framework is no longer updated by NHS Employers and that an improved national appraisal framework was scheduled to launch in 2025/26 (DHSC and NHS England, Feb 2026). Previously, in May 2024, the Thirlwall Inquiry legal team found that the framework was absent from a 2015 government update and that "it is unclear whether any review of the Framework was undertaken" (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.
Report-level response context
Government response
●Department of Health and Social Care · Accepted · 19 Nov 2013
Accepted.
Employers have the freedom to use the Knowledge and Skills Framework to develop their own local arrangements to ensure that dignity, respect and leadership is fully reflected in staff training and development and that capability, learning and development is part of local appraisal systems. This is made clear in the national Agenda for Change agreement which links pay progression mor strongly to performance from March 2013, for more than 1.1 million NHS staff. NHS Employers are already working hard to help employers realise the benefits of the new national agreement on performance.
The Department of Health will commission NHS Employers to encourage NHS organisations to strengthen their local knowledge and skills frameworks so that there is a clear line of sight between the NHS Constitution, the values and behaviours set out in the ‘6Cs’ of Compassion in Practice, the vision and strategy for nursing in England, and local values, performance and appraisal systems.
In addition, the Nursing and Midwifery Council’s standards for competence require nurses to demonstrate their potential to develop management and leadership skills during their period of preceptorship after registration and beyond. This means that the public can trust the newly registered nurse to be an autonomous and confident member of the multi-disciplinary or multi-agency team, and to inspire confidence in others. Nurses can then become more involved and responsible for the planning and delivery of care and improving future services. NHS Employers will encourage NHS organisations to make the necessary links with the work the Nursing and Midwifery Council is leading on revalidation as they develop new local performance and appraisal arrangements.
Delivery
●DHSC and NHS England state no delivery position · 27 Feb 2026
The Knowledge and Skills Framework is no longer updated by NHS Employers. Please see recommendation 193 in respect of the annual appraisal of nurses.
NHS England has developed the NHS Leadership Competency Framework for Board members (February 2024), around six competency domains which reflect the NHS values. An independent evaluation is planned for 2025.
Planning is also taking place for an improved national appraisal framework for all staff, which is due to launch in 2025/26.
Please see response to recommendation 194 above on approaches to appraisal for all NHS staff.
●Department of Health and Social Care says in progress · 11 Feb 2015
With Health Education England, NHS Employers has developed a mapping tool to allow local organisations to map their values to those in the NHS Constitution. NHS Employers has also produced guidance for employers linking pay progression, appraisal and performance management to values and commitment to patient care. This includes a number of resources to support employers including good practice case studies and a model policy. Further resources including case studies and podcasts will continue to be developed during the year.
What other bodies have found
●Thirlwall Inquiry legal team · 15 May 2024
This recommendation was accepted by the Government.
In the January 2014 Hard Truths report, the Government said had the Freedom use the Knowledge and Skills Framework to develop their own local arrangements to ensure that dignity, respect and leadership is fully reflected in staff training and development and the same is part of local appraisal systems.
The Knowledge and Skills Framework was not mentioned in the 2015 Culture Change report and it is unclear whether any review of the Framework was undertaken.
How this page is built
The recommendation and the government responses are verbatim from primary documents. Delivery statements and other bodies' findings are shown in their own words, each with its source. The summary is written by this site and labelled as such. The Index does not paraphrase sources or characterise intent; it records what has been published.