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NHS England to rollout '6Cs' nursing values to all health service staff

Hospital porters, caterers, doctors and trust chief executives will be asked to embrace the “6Cs,” under plans to extend the set of core nursing values to all staff working in the NHS in England, Nursing Times can reveal.

The principles, which form the bedrock of the Compassion in Practice national nursing strategy, are to be rolled out to everyone in the NHS from July, one of England’s most senior nurses has told Nursing Times.

NHS England said the move was in response to demand from other professions, and came on the back of the “phenomenal success” of the initiative within nursing.

“Nurses have shown real leadership”

Juliet Beal

The 6Cs – care, compassion, courage, communication, commitment and competence – are a central plank of Compassion in Practice, which was drawn up by NHS England chief nursing officer Jane Cummings and launched in December 2012.

“In the last 15 months or so the 6Cs and those values and behaviours have started to inspire other professions across the NHS – and not just clinical professions,” said Juliet Beal, NHS England’s director of nursing: quality improvement and care.

Juliet Beal

Juliet Beal

“The rollout is for everybody who works in the NHS, from a ward clerk or porter to frontline staff, consultants and chief executives. It really is aimed at everyone.”

She said nurses and midwives should be “incredibly proud” to be at the forefront of what she described as an “amazing social movement”.

“Nurses have shown real leadership,” she said. “And that’s not about the central team that has been working on it, but nurses and midwives on the ground, at the frontline, who have inspired others.”

Ms Beal said there had been a “huge amount of interest” in the 6Cs and she and her colleagues had already given presentations across the country to diverse groups, including healthcare scientists, hospital caterers, allied health professions, doctors, and chief executives.

“Nurses and midwives often ask why doesn’t this apply to doctors and allied health professions”

Juliet Beal

She said applying the values to the whole of the service was about “creating the right culture to provide really excellent care”. “Even if you’re working in finance you still need a set of values for working in that care setting,” Ms Beal added.

Questioned whether she feared that extending the initiative to all NHS workers would remove ownership of the scheme from nurses, and risked diluting the message, she said: “I don’t think that is a risk.

“The 6Cs are well embedded and often nurses and midwives ask ‘Why doesn’t this apply to doctors, allied health professions?’. They think the same values and behaviours should apply to all people across the NHS,” she said. “That’s the feeling I have got.”

Ms Beal said a key to the nursing strategy’s success was that its six core values had been underpinned by a framework setting out various action points at local and national level, which were backed by the Department of Health, Public Health England, Health Education England, regulators, employers and nursing unions.

This includes commitments specific to nursing, which cover staffing levels, support for nurses, leadership within the profession and ways to measure and monitor quality care.

Ms Beal said that, while the 6Cs would stay the same, the support framework may well be different for different professions.

“People will need to develop those values in a way that’s relevant to the place they work in,” she said. “It’s not something we’re going to be imposing on people to do in a certain way.”

The national rollout will begin with an event in London on 4 July, which will be called The 6Cs for Everyone – Let’s Start the Conversation. This will be followed by four regional events.

“The most important thing is for everybody to get engaged in this”

Juliet Beal

Ms Beal said her team at NHS England was working closely with the NHS Clinical Leaders Network – a national network for practicing clinicians in England – to look at ways of engaging different healthcare professions. Meanwhile, the 6Cs Live! website will be developed to make it relevant to other staff groups.

Ms Beal said nurses and midwives would be key in spreading the word about the 6Cs to other staffing groups. “They can start to get other professions involved in what they’re doing at ward level and trust level,” she said.

“The most important thing is for everybody to get engaged in this, talk about it locally in team meetings, and in particular in multi-disciplinary teams in trusts or clinical commissioning groups,” she told Nursing Times.

Readers' comments (36)

  • I've never, ever heard any colleague even mention the 6C's let alone wonder why they or it or whatever don't apply to others. A clear sign of the disconnect between those at the top and those on the shop floor.

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  • Yawn. Yet another silly fad that'll be forgotten about in a couple of years.

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  • only a nurse could think of this and give it a label. as a hcw this is what you do all the time. giving it a fancy label will not make lazy nurses any better , and the good ones do not need this nonsense. watch how many adhere to the principals of hand hygiene

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  • *only a nurse could think of this and give it a label. as a hcw this is what you do all the time. giving it a fancy label will not make lazy nurses any better , and the good ones do not need this nonsense. watch how many adhere to the principals of hand hygiene*

    Or any lazy HCW for that matter Rodney Michael Tracey

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  • What a load of old twaddle

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  • we've been teaching on this for months

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  • Why? We have the NHS constitution with NHS values... This is just causing confusion and wasting people's time. The NHS constitution was put in place, then we put something in for nurses, now rolling that to everyone when we have already done that

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  • Common values of a person working for the NHS should be core their their being - the fact that we actually need to write 6 words, brand them, and make out that they are groundbreaking is worrying in itself.

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  • It doesn't hurt to remind everyone what the values of all those who work in the NHS are, however i do object to the implied comment that those of us who are not midwives or nurses don't work to a set of core values, the NHS constitution and values, the HCPC code of professional conduct and our own professional codes cover the new 'nursing' 6 c's more than adequately.


    “Nurses and midwives often ask why doesn’t this apply to doctors and allied health professions”

    Juliet Beal

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  • "It doesn't hurt to remind everyone what the values of all those who work in the NHS are, ..."

    I think you will find that most well qualified staff already know and those who don't shouldn't be there!

    hopefully means an end to double values where staff show one set towards their patients and exhibit entirely different and often very negative and destructive ones to their colleagues!

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  • It would be great to see an end to double values, however until the NHS learn to recruit using values there will always be that danger (and i have first hand experience of how vicious staff can be).
    The values have to apply to every member of staff not just the well qualified and I like any other member of staff need refreshers every now and then ! I would rather have the reminder than have another Francis report.

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  • I think this is a step in the right direction following the events in the Francis Inquiry. Clear structured expectations which can be identified by everyone, will enable less satisfactory practice to be recognised and hopefully reduced.

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  • I wonder how much this new initiative cost? Is it another form I will have to complete every hour, like the Intentional Rounding tool, I wonder?

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  • jackie Hughes | 23-Apr-2014 4:05 pm


    people are either kind, caring and compassionate or they are not. those who are not won't change and it is entirely unnecessary and even insulting to remind those who are, although they will hopefully have the qualities to ride above it. good selection is vital although it is not always possible to tell in the space of a series of interviews and tests how people really are and will react under different circumstances. where I worked we had a three month trial period during which time staff could be dismissed at very short notice.

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  • Vague and unenforceable value statements for all! Saviour of the NHS Jane Cummings! Definitely not a political smokescreen!

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  • As a specialist nurse I get to see staff in all areas, both hospital and community, and today asked a total of 43 nurses what they thought of the 6 C's. Not a single one knew what I was talking about. "Well embedded" and "huge amount of interest"? As many commentators have said, people generally are either compassionate or not, the other C's are already part of practice generally - competencies abound, communication is held up by poor IT systems and lack of admin staff to type letters, arrange appointments etc, courage is rewarded with ostracism, and what is missing is a big "R" - resources, and a big "F" - funding.

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  • Anonymous | 23-Apr-2014 11:18 pm

    good and very true comment.

    busy hard working nurses probably don't have time to read NT and the articles about the "Sick C's"

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  • The 6c's should be taught in kindergarden and primary school. Teach good values young, because once grown up the target has moved on too far to hit.

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  • I am involved in a complaint we have made to a Mental Health Trust. Our family has been treated appallingly by the Chief Executive during the process of the complaint, causing immense upset and stress. That same CE, a nurse, blogs and twitters about compassion and being open and honest. Words and silly slogans mean nothing unless they practice what they preach.

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  • Anonymous | 23-Apr-2014 2:06 pm

    Common values of a person working for the NHS should be core their their being - the fact that we actually need to write 6 words, brand them, and make out that they are groundbreaking is worrying in itself.


    So true

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