The set of national nursing values known as the “6Cs” have “sold the profession short” and will have faded out of use in a few years’ time, claimed delegates at an event last week.
The 6Cs, the best known part of the national nursing strategy for England Compassion in Practice, were introduced in 2012 following the Francis report and have subsequently been rolled out to other professions in the NHS.
They were the subject of a formal debate last Thursday, which was organised by academics and titled “We need to talk about the 6Cs”.
“We need to be held to account by more things than the 6Cs”
The organisers of the debate at London South Bank University claimed the 6Cs had “received mixed responses in the healthcare community”, and that many commentators had challenged their focus on individual nurses rather than the environments and constraints within which they work.
“There have been numerous informal discussions, particularly on social media, [about the 6Cs] but until now there has not been a formal debate,” they said. “We want that to change.”
Some present at the event said that, while the values the 6Cs stand for – care, compassion, competence, communication, courage and commitment – were to be “applauded”, they did not ensure standards of care were being met.
Professor Tony Butterworth claimed that the Nursing and Midwifery Council’s new code of conduct would prove to be a more powerful tool for change.
Speaking during the debate on whether the 6Cs improved care, he said: “We need to be held to account by more things than the 6Cs. I applaud them, but it will be the code of practice that holds us to account – not the 6Cs.”
When later asked what the future of the 6Cs would be, he said: “They will decline, as they should. They will go to a place where they will not become less important, [but] they will decline in their prominence.”
“I’m not so sure the 6Cs have a life beyond this next year or two,” he added.
Professor Butterworth said he was not aware of any evidence to suggest the 6Cs had improved patient outcomes or the working lives of staff, but said he would like to see some commissioned.
“We need to big up our academic credentials and let the world know educated nurses are caring nurses”
Meanwhile, Stella Backhouse, who writes the Grumbling Appendix nursing blog, said that while the values behind the 6Cs were important, it was difficult for nurses to maintain them because of the “highly challenging” working environment they were often in.
Ms Backhouse said systemic problems within the NHS should be addressed to ensure standards of care are being met, rather than “simply repeating this [6C] mantra over and over again”.
She also said the 6Cs failed to describe the complexity of the [nurse] role, claiming they “sold [the profession] short”, because they did not highlight the critical thinking required for nursing.
“We need to big up our academic credentials and let the world know educated nurses are caring nurses,” she told the audience of nurses and academics.
But Professor Juliet Beal, NHS England’s director of nursing quality improvement and care, spoke out in support of the 6Cs.
She said she believed there was “quite a bit of qualitative evidence” available to support their impact on care, but noted that it needed to be collated. She also acknowledged that quantitative evidence would be harder to gather.
Professor Beal said the 6C should be viewed as part of a whole range of tools that should be used to address problems within failing trusts. “The 6Cs is about having a value set,” she said.