Recommendation 8

Subcontractors abiding to NHS values

Contractors providing outsourced services should also be required to abide by these requirements and to ensure that staff employed by them for these purposes do so as well. These requirements could be included in the terms on which providers are commissioned to provide services.

The NHS Standard Contract requires all providers to have regard to the NHS Constitution. NHS England will strengthen this requirement in respect of subcontractors in future.

The care patients receive should reflect NHS core values, as outlined in the Constitution, regardless of whether staff have been externally contracted. NHS commissioners are committed to ensuring core values permeate provider organisations and the wider system.

By December 2013, NHS England will amend the NHS Standard Contract for 2014/15 to require providers to ensure their subcontractors fully understand, and abide by, the importance of the Constitution.

NHS England will also include an equivalent requirement in November 2013 in standard contracts for commissioning support services. This will ensure the values outlined in the Constitution extend beyond providers of services through the wider system.


NHS England published the NHS Standard Contract for 2014–15 in December 2013. In line with recommendation 8, the provisions of the NHS Standard Contract were revised to strengthen the requirements on all providers of commissioned healthcare services (other than primary care), including all staff and all sub-contractors, to abide by the NHS Constitution. The specific wording of the 2014/15 NHS Standard Contract now reads (Service Condition 1.3): “The Parties must abide by and promote awareness of the NHS Constitution, including the rights and pledges set out in it. The Provider must ensure that all Sub-Contractors and all Staff abide by the NHS Constitution”.