Recommendation 197

Leadership training for nurses

Accepted in part
Training and continuing professional development for nurses should include leadership training at every level from student to director. A resource for nurse leadership training should be made available for all NHS healthcare provider organisations that should be required under commissioning arrangements by those buying healthcare services to arrange such training for appropriate staff.

Healthcare organisations have a responsibility to ensure that their staff and teams are appropriately trained and continuously developed: having properly trained staff is one of  the requirements they have to meet to register with the Care Quality Commission.  The NHS Leadership Academy core programmes will provide a structured and robust leadership development education from entry level to executive level. Focussed on leadership for compassionate and effective care, the programmes will provide development on the skills, knowledge, behaviours and attitudes needed at every level to create a climate for staff that puts the patient first.

Action areas under Compassion in Practice, the vision and strategy for nursing in England, include:

  • new leadership programme for ward managers, team leaders and nursing directors based on values and behaviours of the ‘6Cs’ of Compassion in Practice (care, compassion, courage, communication, competence, commitment)
  • providers to review options for introducing ward managers, team leaders and nursing directors based on values and behaviours of the ‘6Cs’
  • commissioning leadership role (build into Action Area 4 in Compassion in Practice); and
  • contracts to address the percentage of staff who have accessed leadership development

Arrangements for training are primarily the responsibility of providers, but when commissioners deem it is necessary, in order to ensure the delivery of services by staff with the right skills, they can set training requirements in their contracts with providers.

The Nursing and Midwifery Council published new standards for all pre-registration nursing programmes in 2010 which must be followed at all the universities they approve to run nursing courses.  The previous 2004 standards were updated and strengthened as a result of the findings of the first Francis Inquiry and emerging evidence at that time. The first nurses to have followed programmes approved against these new standards will commence practice in 2014.

The Nursing and Midwifery Council will be undertaking a full evaluation of these new education standards, commencing in 2014, and will have particular regard to the issues of caring and compassion. This will give a proper evidence base for any further revisions to these new standards, and the Nursing and Midwifery Council will consider this recommendation in parallel with their evaluation.

Although the overarching national standards are in place, the detail of the nursing curriculum is dynamic. Employers, service providers and universities are now brought together in local education and training boards, as part of the Health Education England system, to ensure all NHS funded courses are fit for purpose and reflect service needs.  This new part of the system is expected to recognise the importance of Compassion in Practice and the values and behaviours it describes in the ‘6Cs’, to be part of the local review of courses and incorporated into the detailed undergraduate nursing curriculum.   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.

Health Education England and the Nursing and Midwifery Council will continue to collaborate on ensuring the undergraduate nursing curriculum meets patient need.


The Nursing and Midwifery Council has commenced the evaluation of their standards for pre-registration education for nurses and midwives. Central to the evaluation are questions about the effectiveness of standards in preparing nurses and midwives for their professional roles and responsibilities which include care, compassion and leadership.

The Nursing and Midwifery Council has appointed IFF Research to undertake the independent evaluation of pre-registration education for nurses and midwives. They are expected to submit their interim report to the Nursing and Midwifery Council in February 2015 at which point the findings will be shared with Health Education England. The Nursing and Midwifery Council’s final report should be available by September 2015.

The outcomes of the evaluation will provide an evidence base for future reviews of their pre-registration standards for education so that they can, where necessary, enhance the UK standards for nurse and midwifery competence and education.