One of the greatest things you can give a clinician or a manager is time, be it to lead, to see more patients, to have capacity to think of better ways to develop and deliver more services, or to be more strategic etc.

While the Francis Report highlighted many examples of appalling care at Mid-Staffordshire Hospital, this is not the experience of healthcare to the vast, vast majority of patients and their families. Quite the opposite, the NHS is still by far the most popular of all public institutions – including the monarchy.

England’s Chief Nursing Officer, Jane Cummings launched the 6Cs strategy which set out the share purpose of nurses, midwives and health visitors against the backdrop of the Francis Inquiry. The 6Cs are;

The 6 C’s


Delivering high quality care is what we do. People receiving care expect it to be right for them consistently throughout every stage of their life.

Compassion6Cs of Nursing

Compassion is how care is given, through relationships based on empathy, kindness, respect and dignity.


Competence means we have the knowledge and skills to do the job and the capability to deliver the highest standards of care based on research and evidence.


Good communication involves better listening and shared decision making – ‘no decision about without me’


Courage enables us to do the right thing for the people we care for, be bold when we have good ideas, and to speak up when things are wrong.


Commitment will make our vision for the person receiving care, our professions and our teams happen. We commit to take action to achieve this.

The six areas for action are;

  1. Helping people to stay independent, maximising well-being and improving health
  2. Working with people to provide a positive experience of care
    1. Delivering high quality care
    2. Measuring its impact
    3. Building and strengthening leadership
    4. Ensuring we have the right staff, with the right skills in the right place

So, what does all this have to do with Health Service 360? The answer lies in a question Jane Cummings asked in a Twitter chat in October 2012 about the 6Cs when she asked “What about using the 6Cs as a basis for appraisals and 360 feedback? This could help embed the culture of compassionate care”.

In the policy document, training and development of all staff reflecting the 6Cs is seen as crucial and “should be embedded throughout career pathways,

including recruitment, education and training, organisational culture and the appraisal and development of staff’(p9).


360 feedback has to be about more than just ticking a box in the post Francis era, or as a means to revalidation. It’s an incredibly powerful exercise, one about understanding yourself and the impact you have on those around you. Understanding how the way you are perceived aligns with your values and those of your Trust or organisation. This is where the 6C’s come in they lay out a standard, a values framework all nurses can be proud to get behind, and why wouldn’t we want to be measured against the essence of who we are, the attributes we most value.

Health Service 360 is on a mission to create 360 feedback that make a difference, frameworks that matter to people in the NHS, 360 frameworks that align with what we aspire towards.  For more information contact