How the NHS Leadership and management framework was developed
The Leadership and management framework has been co-developed by NHS England, the Chartered Management Institute (CMI), KPMG, the Florence Nightingale Foundation and the Faculty of Medical Leadership and Management. It is based on extensive engagement across the NHS and wider health and care sectors. The code has been specifically co-created with social care and has recently been formally incorporated into the refreshed social care leadership qualities framework (LQF) and aligned with the care workforce pathway.
The framework draws on research and practical experience of what managers need from similar industries and the public sector, both in the UK and abroad. Healthcare staff at all levels have fed into it.
Since August 2025, NHS England has tested and refined the framework with 200 NHS organisations, mapping out what support for managers already exists, how organisations will use the framework and how well the supporting products – including this microsite and user guidance – work.
Implementing the framework: what happens next?
NHS England will monitor how the framework is used across the NHS. We will look at the uptake of the self-assessment, the 360° tool and the learning modules. Data will be collected centrally and shared with organisations in anonymised, aggregated form. There will be no need for organisations to complete a data return.
The framework will be built into appraisal. Managers and staff will use it to assess performance, identify gaps and plan development. Most people will complete an assessment every year to support these conversations. A new standard appraisal framework, which will apply to all NHS staff, not just leaders and managers, is also being developed.
Implementation will be phased so organisations have time to build the standards into existing processes. This includes aligning local policies, training, recruitment and communications, and supporting staff to complete assessments and their development activity. All managers will be expected to use the framework and to work to meet its standards – and it applies to anyone with leadership or management responsibility in an NHS funded service – whether in a clinical or non-clinical role.
NHS England has been working with clinical regulators, such as the General Medical Council and the Nursing and Midwifery Council to make sure existing leadership and management components of clinical regulatory frameworks are aligned with the new standards. Implementation at board level is under review and the board member leadership competency framework (LCF) currently remains in place for 2026/27 for the purpose of fit and proper persons test assessment at board level. The ambition is to work with senior leaders in updating the standards for 2027/28 onwards, so the two frameworks align.
NHS England has been working closely with the devolved nations, and NHS Wales will be launching the same framework to their leaders and managers in summer 2026. We are also exploring how implementation of the framework can be included in the Care Quality Commission’s Well-led assessment.
Learning and development
National learning and development offers will be updated to match the framework including all Leadership Academy programmes, the NHS graduate management training scheme, bitesize learning and regional offers. Free learning modules will support each competency, with a full national development curriculum due in late 2026. Organisations are encouraged to continue using and developing their own training programmes, but the expectation is that, over time, they will align with the framework. The new NHS College of Leadership and Management will have a role in quality assuring all NHS-funded leadership and management development against the curriculum.
Assessment tools and feedback
New self-assessment and 360° feedback tools will support the framework. They will be free and link directly into appraisal and development planning. The data collected will help organisations understand workforce needs and target development more effectively.
The existing Healthcare Leadership Model 360° tool will close in November 2026 and be replaced by the new 360° tool.
Once we have organisations’ contact details, the data will be shared each month. In the first instance this will include only the numbers of self-assessments completed in an organisation. We expect to add breakdowns of the data by protected characteristics, levels, and band in the future. By early 2027/28, we expect to be offering enough data at competency level to support learning needs analyses at both local and national level. This will help organisations understand where any further development is needed for their staff. We are currently exploring the possibility of the data being included in the model health system dashboard. This will not happen until at least April 2027.
The Healthcare Leadership Model (HLM) and its existing 360° feedback tool will continue to be supported by NHS England until November 2026. However, it will not be available nationally after November. We will recommend that organisations stop using it and adopt the new framework-aligned 360° tool. Credits on the existing Healthcare Leadership Model feedback tool will need to be used by November 2026.
The new 360° tool will be free at the point of use and on the same platform as the self-assessment. It will be an unfacilitated model. If organisations want to have a facilitated option, it will have to be procured locally. We are currently looking into the possibility of having a training module to help existing Healthcare Leadership Model 360° facilitators move to the new 360° tool.