NHS Staff Standards FAQs

NHS boards and executives are responsible for delivering the new standards. Oversight will be through the NHS Oversight Framework, as shown in the questions below. Local trade unions and staff networks will help shape local implementation plans and ensure they are put into practice. Boards are expected to create space for staff to share their views, so these can inform delivery.

Following the launch of the new standards, NHS organisations are expected to begin reviewing the requirements and their existing staff experience programmes straight away. 

A new score in the NHS Oversight Framework (see below) will be in place from the start of 2026/27. This will inform segmentation and 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 make staff experience a core priority for every organisation. Boards and executive teams are accountable for making sure the standards are understood, implemented and monitored, with the same level of focus given to other organisational priorities such as finance, operational performance and quality of care.

Implementation should be carried out in partnership with staff, staff networks and the recognised trade unions in local partnership arrangements. This approach helps identify what matters most locally, shapes practical actions and ensures that the standards are embedded in a way that reflects the needs of different staff groups and services.

Senior leaders have a visible role in setting expectations for respectful, inclusive and supportive workplaces. They must ensure managers are equipped to lead well, and that 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. Different contractual arrangements will affect how they are applied in practice. For example, as agency staff are not employed directly by the trust, elements 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. The latest staff survey results show that 73 per cent of staff feel listened to by their line manager and 70 per cent feel their manager works with them to help solve problems. It is important to make sure this is consistent across teams and organisations.

The line management standard sets out the steps employers should take to ensure that line managers feel supported and can carry out their role effectively. It provides a clear and consistent baseline for good line management, including regular and 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. A compassionate and capable line manager is often the main route through which staff experience the standards in practice. Feeling able to raise issues with a trusted line manager, and having confidence that they understand, follow and apply organisational procedures, is critical to identifying and addressing concerns about racism, violence, sexual safety, health and wellbeing or flexible working.

Many line managers do not always have the time, capacity or tools to support their staff in the way they want to. Data from the 2025 pulse surveys show that line managers are more likely to report stress than non‑line managers, and that stress is rising faster for this group. The data also shows that the least engaged line managers are those aged 21 to 30, suggesting early‑career line managers face the greatest challenges.

We recognise the pressures of fulfilling a line management role alongside wider duties, including clinical responsibilities. The line management standard therefore sets out how employers should enable and empower line managers to prioritise the expectations 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. These relationships 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. It complements the framework and includes it within the ‘actions for employers’ section, making alignment with the NHS Leadership and Management Framework a requirement for organisations.

Together, these frameworks move good and consistent line management from an aspiration to a requirement, helping to drive sustained, system‑wide improvement.

The standard sets clear expectations for NHS employers on the steps they should take to reduce the risk of work‑related mental or physical harm. 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 wider 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 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 standard is designed to drive evidence‑based improvements, and each organisation’s starting point will be 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 shows that 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, developed in partnership with the SPF, which sets out clear actions that organisations must take to protect staff.

There is significant work underway to help organisations 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. It is mandatory from 2026/27 as part of the NHS Standard Contract. The staff standard provides further assurance that the VPR standard will be implemented and embedded, and that employers will take the necessary interventions.

Work also continues with employers and trade unions to implement the recommendations in the SPF VPR report. This includes improving security, ensuring cases are reported and investigated, providing better training for staff on de‑escalation and incident response, and strengthening post‑incident support.

The SPF violence subgroup has commissioned several pieces of work to improve organisational responses to staff violence. These include safe working practice guidance, a VPR data reporting framework to standardise how NHS providers record and report incidents of violence and aggression, and a new communications campaign. 

Work on these resources continues and will support organisations as they implement the violence prevention and reduction staff standard.

The sexual safety standard, along with the other five standards, will be measured through a combined metric in the NHS Oversight Framework. Although this produces a single score, organisations will be able to see how they have performed against the NHS Staff Survey questions that feed into it. This will help organisations understand how they are performing against the sexual safety standard.

Through this process, and wider assurance mechanisms, NHS England will be able to step in and support organisations that may not be performing well.

All standards, including the sexual safety standard, will be measured through the NHS Oversight Framework and other assurance processes. This ensures clear consequences where organisations fail to act on unwanted, inappropriate or harmful sexual behaviours in the workplace.

The standard also sets out clear actions that organisations must take. This includes ensuring they have robust policies and processes in place for dealing with sexual misconduct, ensuring all staff complete 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, particularly ethnic minority staff, and ensuring they feel safe working in the NHS. Performance against the NHS staff standards – including the standard on tackling racism – will be measured through the NHS Oversight Framework, with real consequences for organisations that are not delivering.

The standard also sets out clear actions organisations must take to tackle racism. This includes reinforcing the role of senior leaders at board level and ensuring there are visible consequences for racist behaviour.

The standard on tackling racism is separate from the Lord Mann review into antisemitism and racism, but the two pieces of work complement each other.

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 for creating further progress across NHS systems. It sets 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 between the data points in the EDI improvement plan and the staff standard on tackling racism. This ensures the focus on improvement can continue, building on the work already underway.

The standards set out clear actions organisations must take to improve flexible working so it is encouraged, supported and fairly considered. Flexible working should be part of everyday practice, creating a “flexible first” culture rather than being treated as an exception. Requests must be considered objectively and not unreasonably refused, and where agreement is not possible, alternatives should 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 as 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. 

Continually refining data processes allows organisations to better understand needs and outcomes more clearly, ensuring that changes do not inadvertently create additional pressures for organisations and staff.

The standard builds on existing rights in legislation, NHS contractual provisions and national guidance. This includes 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. This new score reflects performance across all six of the standards, contributing to an organisation’s overall segmentation.

The score is based on the NHS Staff Survey (NSS) results, which relate to each of the six standards.

The staff standards will also be reflected in the upcoming update to the provider capability assessment process, alongside changes that emphasise the importance of staff engagement and experience. This will help ensure boards provide assurance that staff experience is being given a high level of priority.

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 it to the scores of similar organisations. The NHS Staff Standards NHS Oversight Framework score will be included in the dashboard from the quarter one update. 

You can also 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. 

Although only the overall score is included in the NHS Oversight Framework, organisations will also be able to see their performance against each of the six individual standards on the Model Health System’s NHS Staff Standards page. This supplementary data will be available shortly. 

Ensuring the new standards are reflected in the NHS Oversight Framework is an important step in making sure NHS organisations prioritise staff experience in the same way they do other key metrics.

To support this, further data and resources will continue to be developed to help organisations understand their performance and to help staff check progress. This may include additional data to show whether the full breadth of the standards is being implemented and to provide assurance that changes are improving staff experience.

There are other sources of data that can help you understand an organisation’s performance on staff experience, these include:

• National Quarterly Pulse Survey
• NHS Workforce Statistics
• National Education and Training Survey

Each staff standard also highlights other data sources you can use to understand your own performance and identifies those that may be included in future updates.

Further data sources and quarterly reporting will be explored to help organisations and individuals assess progress against the standards. This will draw on existing reporting wherever possible to provide better insight into staff experience while avoiding additional data collection burdens.

The new score has been introduced into the NHS Oversight Framework and the first scores will be included in the quarter one 2026/27 results. It affects an organisation’s segmentation score for both the overall NHS Oversight Framework 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 on NHS Staff Survey questions that align to each of the six standards. Each standard carries equal weighting. A sub‑score is created for each standard and these are combined to produce a single overall score. The detailed methodology is set out in the NHS Staff Survey Technical Guidance to ensure transparency. The updated 2026/27 guidance is currently available on NHS Futures and will be available on the main NHSE website in due course. 

The questions used to calculate the overall score for the NHS Staff Standards in 2026/27 are grouped below by standard.

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 that the six standards set out. The results of the new score for the standards alongside the existing staff engagement score will be used 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 based on selected NHS Staff Survey questions that align with the requirements set out in the staff standards.

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

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

Access full details of the methodology used for developing the overall score in the NHS Oversight Framework in the NHS Oversight Framework Technical Guidance. 

Available data will continue to be reviewed to ensure the staff standards NHS Oversight Framework score can 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. 

Ensuring a consistent approach across NHS organisations and for everyone working in health services is important. Changes need to be introduced at the right time so staff and employers are clear about what is expected.

The new standards are a key requirement to ensure NHS organisations reflect the importance of staff experience. The assessment will include a requirement for organisations to show how they are improving staff experience and how staff are involved in shaping these improvements. This will form part of the people and culture domain. 

If a trust’s return is concerning — for example, if they state they do not use or act on staff information to improve experience and wellbeing or if external evidence contradicts the trust’s self‑assessment, regions may reflect this in the capability rating and request follow‑up action. External evidence could include a poor staff standards score (such as being in the bottom quartile) or serious staff issues raised through staff governors, Freedom to Speak Up concerns or CQC well‑led reviews.

Self‑assessments take place once a year, but regions can revise capability ratings during the year if more up‑to‑date information becomes available.