F217

Common selection criteria

Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013

Government responseDepartment of Health and Social Care: Accepted in part (Nov 2013)

DeliveryDHSC and NHS England say in progress (Feb 2026)Department of Health and Social Care says completed (Feb 2015)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

A list should be drawn up of all the qualities generally considered necessary for a good and effective leader. This in turn could inform a list of competences a leader would be expected to have.

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 from September 2024 published in February 2026, the Department of Health and Social Care and NHS England recorded progress as ongoing, referring to their response on the Leadership Competency Framework for further detail (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team found that the recommendation had been clearly implemented, noting the NHS Leadership Academy's healthcare leadership model published in November 2013 (The Thirlwall Inquiry legal team, May 2024). The department had previously reported the recommendation complete in February 2015 after that model and new fit and proper persons regulations were established (Department of Health, Feb 2015).

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 · Accepted in part · 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

Accepted in part.
The NHS Leadership Academy has developed, with extensive stakeholder involvement, a new healthcare leadership model for the NHS. In addition to technical competence, board-level leaders must also be ‘fit and proper persons’ in line with the registration requirements of the Care Quality Commission and Monitor.
The standards produced by the Professional Standards Authority (Standards for members of NHS boards and Clinical Commissioning Group governing bodies in England) provide the basis for standards for senior Board-level leaders and managers. The combination of behavioural standards along with technical competence and business processes sends an important signal about the need for leaders who have the right values and behaviour as well as the ability to get the business done.
The public have the right to expect that people in leading positions in NHS organisations are fit and proper persons; and that where it is demonstrated that a person is not fit and proper, they should not be able to occupy such a position. Monitor and the Care Quality Commission are committed to ensuring that, taken together, their processes for registration and licensing reflect these principles. The Care Quality Commission’s inspection regime will include a focus on whether or not an organisation is ‘well-led’.
Monitor’s licence conditions already require providers to ensure that no person who is an unfit person may become or continue as a Director and that they ensure that its contracts of service with its Directors contain a provision permitting summary termination in the event of a Director being or becoming an unfit person.
In order to strengthen this, the Government issued in July 2013 a consultation on Strengthening corporate accountability in health and social care. This proposes a new requirement that all Board Directors (or equivalents) of providers registered with the Care Quality Commission must meet a new fitness test. We are proposing that this test includes checks about whether the person is of good character including past employment history, and if the individual has the qualifications, skills and experience necessary for the work or office as well as the more traditional consideration of criminal and financial matters.

Extract from: 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 in progress · 27 Feb 2026

Please see our response to recommendation 215 above for detail on the Leadership Competency Framework.

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 “Implemented - Ongoing”. Table row: section 18.2 No. 217, PDF page 536-537.

●Department of Health and Social Care says completed · 11 Feb 2015

The NHS Leadership Academy’s new healthcare leadership model for the NHS was published in November 2013. The Model is comprised of nine ‘leadership dimensions’ which set out the qualities that good leaders at all levels in the NHS should express. The importance of each dimension for an individual will vary based on the type of job they have, the needs of the people they work with, and the context of their role within their organisation.

The National Skills Academy for Social Care’s Leadership Qualities Framework describes what good leadership looks like in different settings and situations. It mirrors the NHS Leadership Framework so that it can be applied in integrated services. The Framework describes the behaviours and competencies a good leader should display. The Academy has also developed a series of supporting assessment tools and initiatives that enable leaders to determine what areas they need to improve on in order to become excellent leaders.

The Care Quality Commission is taking forward the development of a ‘fit and proper persons’ test for board-level leaders in the organisations registered with it, whether in the public, private or voluntary sectors. Fit and Proper Persons Test Regulations have been passed by Parliament and are in place in November 2014 for NHS organisations and from April 2015 for other organisations.

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.

Site note: The Inquiry addressed this recommendation to the NHS Leadership Academy, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on 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 accepted in the part by the Government.

In the January 2014 Hard Truths report, the Government said that the NHS Leadership Academy had developed a new healthcare leadership model. The Government also referred to the ‘Standards for members of NHS boards and Clinical Commissioning Group governing bodies in England’ published by the Professional Standards Authority as providing the standards for senior board-level leaders and managers.

In the February 2015 Culture Change report, the Government referred to the NHS Leadership Academy’s new healthcare leadership model for the NHS, published in November 2013, and comprised of nine leadership dimensions, setting out the qualities that it thought good leaders at all levels in the NHS should express. The Government also said that the National Skills Academy for Social Care’s Leadership Qualities Framework described what good leadership looked like in different setting and situations.

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 colours its Extent of Implementation cell for this recommendation green, which it uses to mark evidence, identified by the legal team, that a recommendation has been clearly implemented. Table row: section 16.2 No. 217, PDF page 497.

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.