NHS employers across England are set to face formal accountability for how they treat staff for the first time, under a landmark set of workforce standards that will be published in public league tables.
The measures, developed in partnership with NHS England, trade unions and staff representatives via the Social Partnership Forum, aim to improve staff experience in six key areas: violence prevention and reduction, championing sexual safety, tackling racism, promoting flexible working, strengthening line management, and improving health and wellbeing support.
From July 2026, NHS Trusts in secondary care, including acute hospitals, mental health services and ambulance trusts, will be required to meet these standards. Performance will be assessed through a new headline metric in the NHS Oversight Framework (NOF), meaning staff experience will directly influence overall organisational ratings alongside critical operational metrics such as waiting times and A&E performance.
A Shift to Measurable Accountability
This marks a significant shift in how NHS organisations are held to account. For the first time, employers’ performance in supporting their workforce will be systematically measured and made visible, creating a clear baseline for what staff should expect, regardless of where they work.
Trust leaders will need to demonstrate progress through annual staff survey results, with particular emphasis on how effectively they respond to issues such as violence, discrimination and workplace wellbeing. Actions such as implementing robust prevention measures and responding decisively to concerns are expected to directly impact both staff satisfaction scores and organisational ratings.
Persisting Concerns Over Safety and Respect
The introduction of these standards follows ongoing concerns about staff safety and workplace culture. Despite a declared zero-tolerance approach to racism and violence, NHS staff continue to report unacceptable experiences.
The most recent NHS Staff Survey revealed a rise in violence faced by workers, with 14.47% reporting they had personally experienced violence at work from patients, relatives or members of the public – marking the second consecutive annual increase. Reports of racism and sexual harassment also remain a significant concern across the workforce.
These findings have reinforced the need for stronger, enforceable measures to ensure staff are treated with dignity and respect.
Government Commitment to Workforce Reform
The government has positioned these changes as part of a broader effort to strengthen the NHS as an employer. Recent initiatives include above-inflation pay rises for three consecutive years and improved retention rates across the service. However, ministers acknowledge that more systemic improvements are needed to address workforce challenges.
Minister for Secondary Care, Karin Smyth, said:
“NHS staff are the backbone of our health service, and they deserve to be treated with dignity and respect. The levels of racism, violence and sexual harassment reported by staff are completely unacceptable, and for too long there has been no formal accountability for employers to address them.
These new standards – a 10 Year Health Plan commitment – change that. For the first time, how Trusts treat their employees will be measured and published, because we know that when staff are supported, patients get better care. This government is determined to make the NHS the best employer it can be, and these standards are a landmark step in delivering on that promise.”
Building Towards Long-Term Workforce Improvements
The standards align with wider reforms, including the forthcoming 10 Year Workforce Plan, which is expected to outline additional measures to support staff and modernise working conditions.
There are also plans to extend the framework beyond secondary care in future years, bringing primary care providers, including GPs and dentists, into the same accountability model.
Additionally, the government has recently accepted recommendations from Lord Mann aimed at tackling antisemitism and discrimination within the NHS, including enhanced accountability measures for senior leadership teams.
Implications for NHS Leaders
For NHS leaders, the introduction of these standards represents both a challenge and an opportunity. Improving staff experience is increasingly seen as integral to operational performance, with better working conditions linked to:
- Improved recruitment and retention
- Reduced sickness absence
- Increased productivity
- Better patient outcomes
As accountability becomes more transparent, organisations will need to prioritise cultural change alongside performance delivery, embedding staff wellbeing and safety into core business strategies.
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