Measuring cultural health
Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: Healthcare providers
Government responseDepartment of Health and Social Care: Accepted (Nov 2013)
DeliveryDHSC and NHS England say partially delivered (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)
Recommendation, verbatim from the inquiry
●Inquiry recommendation
Healthcare providers should be encouraged by incentives to develop and deploy reliable and transparent measures of the cultural health of front-line nursing workplaces and teams, which build on the experience and feedback of nursing staff using a robust methodology, such as the "cultural barometer".
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
The Inquiry recommended incentivising healthcare providers to measure the cultural health of nursing workplaces. In commentary of September 2024, published in February 2026, the Department of Health and Social Care (DHSC) and NHS England stated that the National Health Service (NHS) staff survey and NHS People Pulse provide a standardised framework to measure employee experience, with results publicly available (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team found that a guide on implementing the culture barometer was published in April 2017, but noted that it was unclear what incentives, if any, were implemented (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 1 Oct 2026.
About this summary
Report-level response context
Government response
●Department of Health and Social Care · Accepted · 19 Nov 2013
Accepted.
Both teams and organisations should develop ways to measure their cultural health, and act on these measures to improve. Cultural health is a matter for all staff groups; everybody who works in the health and care system is integral to improving and maintaining good cultural health. Many tools and methods are available and the Department of Health and other arm’s length bodies are promoting these. For example, the Cultural Barometer, which was highlighted as a case study in the Government’s initial response to The Inquiry, Patients First and Foremost, is being developed and piloted. The National Nursing Research Unit at Kings College London are evaluating the pilot and are expected to publish their report in November 2013. NHS England supports the use of tools such as the cultural barometer and real time staff experience feedback. The friends and family test for staff will be rolled out from April 2014.
The Chief Nursing Officer is providing leadership through Compassion in Practice, the vision and strategy for nursing in England. Key action areas include:
• developing a set of tools that enable organisations to measure their culture;
• providers undertaking a review of their organisational culture and publish the results;
• reviewing implementation of the cultural barometer once pilots have taken place;
• strategies to secure meaningful staff engagement;
• commissioning leadership role (build into Action Area 4 in Compassion in Practice); and
• commissioning an approach to ensure that staff feedback is being used to develop cultural health of front-line staff.
Delivery
●DHSC and NHS England say partially delivered · 27 Feb 2026
The NHS staff survey and NHS People Pulse now provide a consistent and standardised framework to understand, measure and improve employee experience. Results are publicly available.
●Department of Health and Social Care says in progress · 11 Feb 2015
Promoting positive and learning cultures remains critical to supporting service improvement. The Staff Friends and Family Test was introduced in April 2014. It is a feedback tool for staff, predominantly for local improvement work. It consists of two questions (with options to give free text feedback for each) through which organisations can take a temperature check of how staff are feeling. It is a quicker feedback mechanism than the existing NHS annual staff survey, and will help staff to voice their concerns (on a regular basis if they wish to) and help organisations to respond. Following the first pilot phase of the cultural barometer by King’s College London, further work has taken place in two community and mental health sites to develop the tool further. Piloting will be complete by the end of the year and work is now underway to consider how best to make the barometer accessible and enable uptake. Further information on the barometer is available online.
The Social Partnership Forum produced guidance on staff engagement and partnership working and highlights areas of excellence in NHS organisations where management and trade union representatives work together effectively to identify and resolve issues. The need for this guidance was indicated in Hard Truths and builds on the six key messages developed by the forum to support the development of the values, culture and working environment in the NHS that would best ensure that patients receive safe, effective and compassionate care.
What other bodies have found
●Thirlwall Inquiry legal team · 15 May 2024
This recommendation was accepted by the Government.
In its January 2014 Hard Truths repot, the Government said that the Department of Health was promoting various tools and methods to maintain good cultural health. T
In the February 2015 Culture Change report, the Government said that the Staff Friends and Family Test was introduced in April 2014, providing a feedback tool for staff. Piloting was carried out for the “Culture of Care Barometer”, which resulted in the publication of a guide for how organisations could implement the Barometer in April 2017.
It is unclear what, if any, incentives were implemented.
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.