Training standards for healthcare support workers
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: Not accepted (Nov 2013)
DeliveryDHSC and NHS England say not accepted (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)
Recommendation, verbatim from the inquiry
●Inquiry recommendation
Until such time as the Nursing and Midwifery Council is charged with the recommended regulatory responsibilities, the Department of Health should institute a nationwide system to protect patients and care receivers from harm. This system should be supported by fair due process in relation to employees in this grade who have been dismissed by employers on the grounds of a serious breach of the code of conduct or otherwise being unfit for such a post.
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 Department of Health and Social Care and NHS England stated in September 2024, in commentary published in February 2026, that the recommendation was not accepted by the government (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team similarly found that the government had rejected the recommendation, noting that ministers had instead relied on Care Quality Commission registration standards and guidance on staff appraisal and performance management (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 · Not accepted · 19 Nov 2013
Not accepted, however we intend to achieve the intention behind this by ensuring that organisations have the right staff with the right skills to deliver care in a safe way.
We do not believe that regulation of healthcare assistants and support workers will improve the quality of care. The Nursing and Midwifery Council are an organisation going through a significant change programme focused around delivering their core functions relevant to the regulation of nurses and midwives, and should not be charged with these recommended regulatory responsibilities. In line with the recommendation from the Cavendish Review, the Government has commissioned the Professional Standards Authority for Health and Social Care for advice on how employers can be more effective in managing the dismissal of unsatisfactory staff.
The Disclosure and Barring Service provides a further layer of assurance by helping employers make safer recruitment decisions and prevent unsuitable people working with vulnerable groups.
Delivery
●DHSC and NHS England say not accepted · 27 Feb 2026
This recommendation was not accepted by the Government.
●Department of Health and Social Care says in progress · 11 Feb 2015
The Care Quality Commission’s registration requirements state that all providers of regulated activities must ensure that they have the right staff with the right qualifications, competence, skills and experience to undertake tasks to be performed. Where providers fail to comply, the Care Quality Commission has a range of enforcement powers.
The Nursing and Midwifery Council’s Code of Conduct requires nurses and midwives to delegate effectively by ensuring that anyone they delegate to is able to carry out their instructions, that the outcome of the delegated task meets required standards and that the individual delegated to is supervised and supported. All healthcare assistants and social care support workers should receive consistent high quality training in the fundamental skills of caring, understanding the skills and behaviours needed to deliver good care. That is why the Department of Health is introducing the Care Certificate, which will be a means of ensuring healthcare assistants and social care support workers receive the training and support they need to do their jobs.
Supporting staff can also mean tackling underperformance in a sensitive, fair and robust manner. We should not shy away from this. In response to the Professional Standards Authority’s advice to the Secretary of State, NHS Employers and the National Skills Academy for Social Care (Skills for Care) have been commissioned to develop a resource drawing together content on effective performance management and appraisal of staff providing care. This should support health and social care managers in their responsibilities to manage performance, leading to safer, higher quality care. We expect the resource to be launched in April 2015.
What other bodies have found
●Thirlwall Inquiry legal team · 15 May 2024
This recommendation was rejected by the Government.
In the January 2014 Hard Truths report, the Government rejected the recommendation that the Nursing and Midwifery Council be charged with the recommended regulatory responsibilities for healthcare assistants and support workers. The Government said that it had instead commissioned the Professional Standards Authority for Health and Social Care for advice on how employees could be more effective in managing the dismissal of unsatisfactory staff.
In the February 2015 Culture Change report, the Government referred to the Care Quality Commission’s registration requirements requiring providers to have the right staff with the right qualifications, competence, skills and experience; the Nursing and Midwifery Council’s Code of Conduct requiring nurses and midwives to delegate effectively; and the NHS Employers and the National Skills Academy for Social Care being commissioned to develop a resource drawing together content on effective performance management and appraisal of staff.
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.