Recommendation 9

Professional and managerial codes in the NHS Constitution

Accepted in principle
The NHS Constitution should include reference to all the professional and managerial codes by which NHS staff are bound, including the Code of Conduct for NHS Managers.

We support the principle of making clear which codes staff are expected to follow. However, as the NHS Constitution is intended to be a succinct and enduring document, the details of codes are more appropriately set out in the Handbook to the NHS Constitution rather than the Constitution.

The Constitution already includes a duty for staff ‘to accept professional accountability and maintain the standards of professional practice as set by the appropriate regulatory body applicable to your profession or role’. The handbook, which provides more detailed guidance on each of the rights, pledges and responsibilities included in the Constitution, sets out the relevant professional bodies but does not currently reference the relevant codes of these bodies nor any managerial codes.

When the Constitution is next updated, the Department of Health will consider how best to reflect in the Handbook the codes of conduct including the relevant professional and managerial codes, by which NHS staff are bound at that time.


Sir Robert Francis QC was clear in his Inquiry report that the principal message of the NHS Constitution should be that patients and their safety come first.  In Hard Truths, the Department of Health committed to strengthening the NHS Constitution to make this clearer for patients, staff and the public. To this end, The Government has launched a consultation into, amongst other things, refreshing the NHS Constitution to reflect the recommendations made by Sir Robert Francis QC. The key elements are:

  • duty of candour;
  • safe care and avoidable harm;
  • staff guidance, and;
  • a patient-centred NHS.