F213

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 responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.

Government response

●Department of Health and Social Care · Not accepted · 19 Nov 2013

Speaker not recorded. Source: Department of Health, Hard Truths: the Journey to Putting Patients First, volume 2 (Cm 8777-II), November 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.

Response document: Hard Truths: The Journey to Putting Patients First. Volume Two of the Government Response to the Mid Staffordshire NHS Foundation Trust Public Inquiry: Response to the Inquiry's Recommendations

Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.

Delivery

●DHSC and NHS England say not accepted · 27 Feb 2026

This recommendation was not accepted by the Government.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Not accepted”. Table row: section 18.2 No. 213, PDF page 533-534.

●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.

From: Culture Change in the NHS supporting Annex (annex to Culture change in the NHS: applying the lessons of the Francis Inquiries)

Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.

What other bodies have found

In their own words. These do not change the delivery statement above.

●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.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 213, PDF page 494-495.

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.