NHS Staff Standards FAQs

The boards and executives of NHS organisations are accountable for the delivery of the new standards. This will be driven through the NHS Oversight Framework (see questions below). Trade unions in the local staff side and staff networks will play a vital role in developing local plans for implementation and ensuring they are implemented. So, boards are expected to facilitate staff sharing their views to help inform delivery. 

Following launch of the new standards, it is expected that NHS organisations will take immediate steps to begin reviewing both the requirements set out and their existing staff experience programmes. A new score – which will inform segmentation – in the NHS Oversight Framework (see below) is in place from the beginning of 2026/27 to ensure accountability against the standards. 

Good in year one means: 

• organisations have clear ownership, an honest baseline and a prioritised plan, rather than full maturity
• boards understand their current position against the six standards, have agreed leadership and oversight, are engaging staff and trade unions and have a credible action plan focused on meeting minimum expectations and managing key risks 
• leaders can explain how delivery will be assessed and how they are responding.

The standards are about making staff experience a core priority for your organisation. Boards and executive teams are accountable for making sure the standards are understood, implemented and monitored, with the same level of focus and grip given to other organisational priorities such as finance, operational performance and quality of care. 

Implementation should be done in partnership with staff, staff networks, and the recognised trade unions in local partnership arrangements. This partnership approach will be important for identifying what matters most locally, shaping practical actions, and providing assurance that the standards are being embedded in a way that reflects the needs of different staff groups and services. 

However, it is ultimately up to senior leaders to have a visible role in setting expectations for respectful, inclusive and supportive workplaces; ensuring managers are equipped to lead well; and making sure staff can raise concerns, share feedback and see that action is being taken in response.

The standards apply to all staff working in secondary care, however, we recognise that different contractual arrangements will impact how they are applied in practice. For example, as agency staff are not employed directly by the trust, certain elements of the standards, such as line management and flexible working, will look different. 

Contractual arrangements should take precedence, but the essence of the standards should still be applied to all. 

Effective line management is a strong driver of positive staff experience, and the latest staff survey results show that 73% of staff feel listened to by their line manager and 70% feel their manager works with them to help them with their problems. However, it’s important to ensure that this is consistent across teams and organisations.

The Line Management standard sets out important steps employers should take to ensure that line managers feel supported and are able to fulfil their role effectively. It also sets a clear and consistent baseline for what good line management looks like, including regular, meaningful supervision, appraisal and development, alongside compassionate leadership behaviours. This helps ensure all staff feel supported, listened to and able to raise concerns.

The Line Management standard underpins all other staff standards, as a compassionate and capable line manager is often the main route through which staff will experience the standards in practice. Feeling able to raise issues with a trusted line manager, and having confidence that they understand, follow and will apply organisational procedures, is critical to ensuring concerns about racism, violence, sexual safety, health and wellbeing or flexible working are identified early and properly addressed.

We know that many line managers may not always have the time, capacity or tools to support their staff in the way they want to. Data from 2025 Pulse Surveys show that line managers are more likely to report stress than non‑line managers, with stress increasing at a faster rate. The data also tells us that the line managers who are least engaged are the youngest cohort of 21–30-year-olds, suggesting early career line managers struggle the most. We understand that there are challenges with fulfilling a line management role alongside wider duties such as clinical roles. The standard therefore makes it explicit how employers should enable and empower line managers to prioritise the expectations set out in the standard, through appropriate resourcing, support and organisational leadership. 

The standard makes clear what employers must do to enable and empower line managers to meet expectations. This includes providing sufficient time, capacity, training, and organisational support to prioritise high-quality line management. 

It recognises that staff experience is shaped not only by formal processes, but by day-to-day relationships which influence whether staff feel safe to speak up, trust their manager, and receive support when issues arise. By strengthening both the practical and relational aspects of line management, the standard helps create more consistent, supportive and open working environments in which staff can thrive. 

The Line Management standard does not replace existing leadership frameworks, training programmes or guidance, such as the new NHS Leadership and Management Framework. Instead, it complements the framework and includes it within the ‘actions for employers’ section, making aligning local organisational work with the NHS Leadership and Management Framework a requirement for organisations. These frameworks together move good, consistent line management from an aspiration to a requirement, helping to drive sustained and system‑wide improvement.

The standard sets clear expectations across NHS employers of steps they should take to minimise the risk of work-related mental or physical harm amongst their employees. Employers will need to identify risks to staff wellbeing early, use workforce data and staff feedback, and take targeted, needs-based action before issues escalate, for example, into sickness absence. 

By strengthening board‑level accountability and making wellbeing part of everyday leadership and management, the standard helps create a culture where staff feel safe, cared for, and able to perform well at work. 

The Health and Wellbeing Staff Standard is part of a wider programme of work across the NHS to improve staff experience, safety and wellbeing. This includes the NHS Growing Occupational Health and Wellbeing Strategy; the introduction of Staff Treatment Hubs; and targeted initiatives such as menopause support, guidance for line managers, and accessible resources for staff. 

NHS England is also leading a reform of statutory and mandatory training, which aims to reduce unnecessary training burden, remove duplication, and make required training more effective and relevant for staff. This work is designed to improve staff experience and free up time for patient care, while still meeting legal and safety requirements. 

There is also a broader shift away from relying on training alone to address health and wellbeing risks at work. The statutory and mandatory training review highlights the importance of combining training with wider system level action – such as better leadership, clearer standards, improved data, and stronger accountability – to prevent harm to staff in the first place. 

The intention of this standard is to drive evidence-based improvements and each organisation’s starting point will look different. Employers should use data to identify risk, work in partnership with trade unions, and develop targeted, needs-driven interventions. Boards are expected to have visibility and oversight of this data and to take action where staff experience indicates health and wellbeing is at risk. 

The standard recognises that staff work in very different environments, including community, ambulance, remote and mobile settings. Employers are expected to ensure that health and wellbeing support is equitable and inclusive, even where traditional facilities are not available, and to consider practical alternatives where needed.

The standard builds on and reinforces many of the measures already in place to prevent and reduce violence against NHS staff. This includes the Violence Prevention and Reduction (VPR) standard, which was developed in partnership with the Social Partnership Forum (SPF) and sets out clear actions that organisations must take to protect staff.

In addition to the action being taken via the staff standards, there is significant work underway to support organisations to prevent and reduce violence.

The Violence Prevention and Reduction (VPR) standard, which was developed in partnership with the Social Partnership Forum (SPF), supports employers to understand and manage risks around violence. This has been made mandatory as part of the 2026/27 NHS Standard Contract. The staff standard provides additional assurance that the VPR standard will be implemented and embedded by employers, whilst ensuring the necessary interventions are taken. 

Additionally, work continues in partnership with employers and trade unions to implement the recommendations set out in the SPF VPR report, including improving security, ensuring cases are reported and investigated, providing better training for staff on de-escalating and dealing with incidents, and enhancing post-incident support for staff. 

The SPF violence subgroup has commissioned several pieces of work which seek to improve organisational responses to staff violence including Safe Working Practice guidance, a VPR Data Reporting Framework to standardise how all NHS provider organisations record and report incidences of violence and aggression against staff, and a new communications campaign. Work on these continues, and their publication will support organisations in their implementation of the violence prevention and reduction staff standard.

The Sexual Safety standard, alongside the other five standards, will be measured via a combined metric in the NHS Oversight Framework. Although this will produce a single score for all of the standards, organisations will be able to see how they have performed against the NHS Staff Survey questions that feed into the score. Taken together, this should allow organisations to understand how they are performing against the sexual safety standard. Through this process and wider assurance mechanisms, NHS England will then be able to step in to support those organisations that may not be doing so well.

All standards, including the specific one on sexual safety, will be measured through the NHS Oversight Framework and other assurance processes to ensure clear consequences for a lack of action on tackling unwanted, inappropriate/or harmful sexual behaviours in the workplace.

The standard also sets out clear actions that organisations must be taking. This includes ensuring they have robust policies and processes in place for dealing with sexual misconduct, ensuring all staff complete the necessary sexual misconduct training and fully implementing the actions set out in the ‘Sexual safety in healthcare’ organisational charter.

Tackling racism is critical to improving the experience of all staff, but particularly ethnic minority staff, to ensure they feel safe working in the NHS. The key difference with the NHS Staff Standards is that performance against them – including the standard on tackling racism – will be measured through the NHS Oversight Framework, with real consequences for organisations who aren’t delivering. 

The standard also sets out clear actions organisations must be taking to tackle racism, including reinforcing the role of board level seniors and requiring real visible consequences to be in place for racist behaviour.

The standard on tackling racism is separate to the Lord Mann review into antisemitism and racism, however, both pieces of work complement one another. 

In October 2025 Lord Mann was commissioned to lead a rapid review into how healthcare regulators and the NHS tackle antisemitism and racism at every stage, from employment through to professional oversight. This review considered how regulatory processes, transparency in investigations and reporting mechanisms might be improved. His recommendations included the updating of mandatory training on antisemitism and anti-Muslim Hostility as well as clearer national guidance on uniforms. The Government published and accepted the remainder of Lord Mann’s recommendations on 4th June 2026. 

NHS England’s Equality, Diversity, and Inclusion (EDI) Improvement Plan , published in 2023 has been our pathway to date to create further progress through NHS systems – setting out six high impact actions to create an environment where staff feel they belong, can safely raise concerns, and are empowered to deliver the best care to our patients. There is intentional alignment within the data points in the EDI Plan and the staff standard on Tackling Racism to ensure the focus on improvement can continue based on the good work already underway.

The standards set out clear actions that organisations must take to improve flexible working opportunities so that it is openly encouraged and supported, fairly and equitably considered, and embedded into everyday practice, creating a “flexible first” culture, rather than treated as an exception. Requests must be considered objectively and not unreasonably refused, and where they cannot be agreed, alternatives will be explored. 

Organisation boards are expected to take clear responsibility for improving flexible working, including appointing a board level flexible working champion, owning and delivering a Flexible Working Action Plan, monitoring its effect through workforce data, and implementing preference-based team e-rostering for all frontline workers (where operationally appropriate). 

This will ensure that flexible working opportunities are offered fairly and consistently to NHS staff regardless of organisation and role. 

Flexible working in the NHS means flexibility in how, where and when staff work. Staff have a statutory right to make flexible working requests from day one and employers must handle requests in a reasonable manner and respond within required timescales. The National Flexible Working People Policy Framework sets out details on types of flexible working arrangements, how to make a request, and guidance for managers to support embedding flexible working practices and enable a “flexible first” culture within organisations. 

The staff standard sets out the minimum national expectations for how all NHS organisations must create a positive, fair and transparent culture in which flexible working is normalised operational practice, proactively offered, openly discussed, and consistently applied. 

Improving flexible working is not solely about training, but also about time, capacity, job planning and iterative data maturity. It is essential to recognise that providing staff with the necessary resources and support, such as adequate time allocation and thoughtful job design, can make a significant difference. Furthermore, continually refining data processes allows organisations to better understand needs and outcomes, ensuring that changes do not inadvertently create additional pressures for organisations and staff.

The standard builds on existing rights within current legislation, NHS contractual provisions and national guidance, including the National Flexible Working People Policy Framework, national flexible working toolkits, e-rostering guidance, and NHS Staff Survey measures. Further work is underway with NHS Employers and trade unions through 2026/27 to strengthen data, oversight and shared learning on flexible working.

A new score has been introduced in the NHS Oversight Framework in 2026/27. This new score reflects performance across all six of the standards, contributing to an organisation’s overall segmentation. You can find more information on the NHS Oversight Framework at this link.

The NHS Oversight Framework score is based on the results of questions in the NHS Staff Survey (NSS) that relate to each of the 6 standards.

The Staff Standards will also be reflected in the upcoming update to the provider capability assessment process, alongside revisions to reflect the importance of staff engagement and experience. This will help ensure that boards are providing assurance that they are giving staff experience a high degree of priority. 

There are several ways you can track your performance across the requirements of the staff standards:

The NHS Oversight Framework score: You can see your organisation’s performance against the various scores in the NHS Oversight Framework by accessing the NHS Oversight Framework Dashboards – there are links to dashboards for acute trusts, ambulance trusts and mental health and community trusts. These enable you to see your organisation’s score for the overall NHS Staff Standards score and compare them to the scores of similar organisations. The NHS Staff Standards NHS Oversight Framework score will be included in the dashboard from the quarter 1 update. 

Supplementary data showing sub-scores for each of the six standards: While only the overall score across the standards is included in the NHS Oversight Framework, you will also be able to see your organisation’s performance against each of the six individual standards, alongside the overall score, on the Model Health System’s NHS Staff Standards page. This supplementary data will be available shortly.

Staff Survey data supporting the NHS Oversight Framework score: In addition, you can see your organisation’s performance for each of the NSS questions that make up the overall NHS Oversight Framework score. This can be accessed via the NHS Staff Survey dashboards. Further development is underway to ensure supplementary data can be published to show each organisation’s score for the six individual standards – this will follow later in the year. 

Other data: Each of the six standards detail other sources of data organisations can use to track their performance for each of the standards. This includes, as an example, the Workforce Race Equality Standard (WRES) data (see below for more examples). Organisations should also continue to use and develop their own existing local data to help understand their performance across the standards.

Ensuring the new standards are reflected in the NHS Oversight Framework is a key step to ensuring NHS organisations prioritise staff experience in the same way they do other key metrics. 

To further support this, we will continue to develop additional data and resources to help organisations understand their performance and to help staff across the NHS to check progress. This may include additional data to ensure the full breadth of the standards is being implemented and provide assurance that changes are helping staff. 

There are also some other sources of data and information you may find helpful to understand an NHS organisation’s performance on issues related to staff experience, these include:

• NHS Staff Survey dashboard – this includes data visualisation for:
  • Workforce Race Equality Standard
  • Workforce Disability Equality Standard
  • People Promise theme scores and sub-scores
• Workforce Race Equality Standard data
• National Quarterly Pulse Survey
• NHS Workforce Statistics
• National Education and Training Survey
• Electronic Staff Record data

Each Staff Standard includes other data sources you could use to understand your own performance and highlights sources we will look to include in future iterations. 

To further support organisations and individuals to assess progress against the standards, further data sources and quarterly data will be explored. This will draw on existing reporting as far as possible to ensure we have the benefits of greater insight into staff experience while avoiding the burden on organisations of additional data collection.

The new score has been introduced into the NHS Oversight Framework and the first scores will be included in the Quarter 1 2026/27 results. This new score impacts an organisation’s segmentation score for both the overall NHS Oversight Framework segmentation and the People and Workforce Domain. Further details can be found here regarding how NHS Oversight Framework scores impact performance assessment. 

In 2026/27, the score is based upon questions from the NHS Staff Survey that align to each of the six standards. To ensure each of the standards carry equal weighting, a sub-score for each standard is developed and then these sub-scores are compounded together to create a single overall score for the NHS Oversight Framework. A detailed methodology is set out in the NHS Staff Survey Technical Guidance to ensure transparency – Note: the draft 2026/27 guidance is currently available on NHS Futures for NHS users and will be available on the main NHSE website in due course. 

The questions that are used to derive the single overall score included in the 2026/27 score for the NHS Staff Standards NHS Oversight Framework are:

No – the existing Staff Engagement score is a vital measure of staff experience and will remain in the NHS Oversight Framework. The new score for the staff standards has been introduced to assess delivery against the specific requirements the six standards set out. We will use the results of the new score for the standards alongside the existing Staff Engagement score to facilitate a holistic understanding of staff experience.

The new overall score for the NHS Oversight Framework is a compound score based on performance against all six standards. These are in turn based on selected NHS Staff Survey questions that align to the requirements set out in the Staff Standards.

The NHS Oversight Framework dashboard will only include the overall score. However, the sub-scores for each of the six standards will also available shortly as supplementary data on the NHS Staff Standards Model Health System page. 

Scores for each of the individual NHS Staff Survey questions that are used in the score (including the sub-scores) can also be accessed via the NHS Staff Survey dashboard. 

The full detail of the methodology used for developing the overall score in the NHS Oversight Framework is accessible in the NHS Oversight Framework Technical Guidance. 

We will continue to review the available data to ensure the Staff Standards NHS Oversight Framework score is able to effectively assess delivery across the full range of expectations set out in the standards. This may result in some update to the NHS Oversight Framework score for 2027/28 and beyond. However, we understand the importance of ensuring a consistent approach for both NHS organisations and those working in health services. We will therefore seek to ensure any changes are implemented at appropriate points so that both staff and employers are always aware of what is expected.

The new standards are a key new requirement that aim to ensure NHS organisations are reflecting the importance of staff experience. The assessment will include a requirement for organisations to reflect on how they are delivering improvements in staff experience and supporting staff to have a role in these developments. This will form part of the People and Culture domain. If either; 

1. The trust's return is concerning - e.g. they admit they do not use or act on staff information to improve experience and wellbeing, or 
2. External evidence of a significant lack of duty of care to staff contradicts the trust’s own self-assessment – such as a poor Staff Standards score (e.g. bottom quartile) or the region is aware of, or suddenly learns of, serious staff issues e.g. through staff governors at foundation trusts, Freedom To Speak Up (FTSU) issues or concerns raised by CQC in their well-led reviews, 

then regions may reflect this in the capability rating and can request follow-up action. Self-assessments are carried out once a year, but regions may revise capability ratings in-year in response to more up-to-date information.