Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more


'6Cs must end the years of make do and mend'


One of the major criticisms of the new nursing strategy Compassion in Practice, aka the 6Cs, is that it’s too vague. People are concerned that it’s just words on a PowerPoint slide, with no real meaning behind them.

There was a fear that trusts would go off and interpret them individually, and that nursing would end up with nothing being spread from one organisation to another. The concern was we would arrive at something of a patchwork quilt of good ideas, as so often happens in the NHS - some duplicate work, some differing takes, some reinventions of the wheel.

But that’s not the case according to Jane Cummings, the chief nursing officer for England.

At last week’s Health Innovation Expo, she announced that there is detail behind the plans, and that she would be revealing exactly how all the elements will be rolled out.

The only way to improve standards in the profession is to listen to it, understand what has gone wrong from the nurse’s perspective and put this right

While unable to set out her vision fully until after the government has issued its response to the Francis report - expected next week - she did give some hints about its focus.

The safety thermometer, the cultural barometer and the connection between patient experience and staff experience all got a mention and are set to be part of the new plans to boost nursing.

I am delighted that someone is recognising the importance of happy staff. Nurses spend their time making sure their patients are content, comfortable and cared for. But the duties of the job and looking after really sick people takes its toll. Much has been written about emotional labour but, in some trusts, very little is done to identify and mitigate its effects on nurses.

Ms Cummings talked about the brilliant standard of care in organisations she had visited since taking up the post of CNO a year ago. But she also conceded that standards do vary.

Of course, some of that is down to poor practitioners. These exist in every profession. But far more is down to resourcing, lack of leadership and lack of competence. And a lack of compassion - or rather compassion that was once there but has been beaten out of nurses through years of being ignored or ridden roughshod over.

So the focus of the 6Cs is right. The only way to improve standards in the profession is to listen to it, understand what has gone wrong from the nurse’s perspective and put this right.

The years of make do and mend in nursing need to end. It is time to resource properly, listen carefully and act sensibly. Let’s hope that, with the response to Francis and the full version of 6Cs, we get all of that.

If you haven’t signed our petition, please do so now at Your signature will make all the difference.

Visit our Speak out Safely page to find out more.

Jenni Middleton, editor Follow me on Twitter @nursingtimesed



Readers' comments (14)

  • Those who do not understand the many faceted role of nursing seem to think of it as a type of bedside maid/secretary/administrator, etc. and job that anyone can do with a little basic training. no wonder on this premise, politicians believe it is too costly and salaries and staff can be reduced - it must be all part of their reductionist scheme. Once this is in full swing there will be a huge outcry to bring back qualified and specialised nurses as the consequences on patient care are far too grave and a false economy, but setting up a new system and finding and recruiting suitable nurses from the pool of redundancies, the de skilled or those who have gone into other careers or abroad, and setting up a new training scheme for entrants to the profession to match real needs will be far too costly.

    Unsuitable or offensive? Report this comment

  • Jenni Middleton, I think you need to accept that the "6C's" are like Monty Python's famous parrot- well and truly dead, beyond resurrection, expired, deceased, is no more.

    Unsuitable or offensive? Report this comment

  • michael stone

    Anonymous | 23-Mar-2013 3:54 pm

    The 6Cs are fine as a description of a good 'mindset', but they do not address implementation: they do not explain how to deal with 'bullying of whistleblowers', etc.

    I do not want to kill the 6Cs - I want to see the necessary enviromental changes, to 'power structures, etc', that would allow clinicians to act ethically and to put the 6Cs into practice, ALSO described by Jane et al, and effected.

    Unsuitable or offensive? Report this comment

  • I think the 6 cs have existed in one format or another for many years.Albeit not formally recognized.
    In order to fully implement these recommendations more staff are needed and more compassion for the staff trying their hard pressed best to implement these findings properly!!
    The 6cs should NOT be dead as I think they form the basis of good old fashioned nursing care. Enabling a person and not a condition to be seen??

    Unsuitable or offensive? Report this comment

Show 1020results per page

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.

Related Jobs