NHS Leadership and Management Framework briefing

July 8, 2026July 8, 2026

For the first time, the NHS has a single national Leadership and Management Framework describing what excellent leadership and management looks like in every setting. It brings together a code of practice, standards and competencies for clinical and non-clinical managers and leaders, at every level and across every part of the NHS – from neighbourhood, primary and community services through to secondary and tertiary care.

The framework was co-developed with thousands of NHS managers, leaders and patient representatives, alongside partners including NHS England, Chartered Management Institute, Faculty of Medical Leadership and Management, and the Florence Nightingale Foundation, ensuring it reflects both system expertise and lived experience.

The Framework is a key milestone in delivering the 10 Year Heath Plan and Medium-Term Planning Framework. Organisations and boards are being asked to begin implementation by embedding it into local people strategies, policies, training, appraisal and recruitment, and by aligning existing leadership and management development offers to the new standards. This should include mapping current provision and identifying gaps. The Framework will also support delivery of the NHS Staff Standards, which are reflected in the National Oversight Framework, and should therefore form part of local assurance on management quality, staff experience and improvement.

Organisations should support all managers and leaders to complete the self-assessment and undertake development (including on-the-job learning) towards achieving their level’s required competencies. Boards should monitor local completion and use the data to understand development needs across their organisation.

The NHS Leadership and Management Framework will provide a consistent foundation for leadership and management development across the NHS. It has been published as part of the establishment of the newNHS College of Leadership and Management as the national home for NHS leadership, management and talent excellence.

In partnership with the service and building on the foundations established through existing leadership communities, the College will help strengthen professional identity, support career development, improve talent management, and provide a recognised quality mark for leadership and management. We will work closely with partners to shape the College’s future priorities, development offers and ways of working, with opportunities for organisations and individuals to contribute to its development.

Useful information

NHS Leadership and Management Framework: The new NHS Leadership and Management Framework has been developed to recognise, support and professionalise leadership and management consistently across the NHS, in response to the Messenger Review (2022). The framework sets consistent, professional standards and competencies across all levels of NHS management, clinical and non-clinical, and for the first time a single, national code of practice across health and social care.

Code of Practice: The code highlights the need for improved support for leadership and management across health and social care and called for clear and consistent standards. It sets out, for the first time, the principles and characteristics that all managers and leaders are expected to meet in the sector. The code sets out the core principles and behaviours expected of every manager and leader and equips colleagues with the non-negotiable principles that underpin good leadership and management.

Standards: Standards and competencies at defined levels of leadership and management from entry level to executive level, setting out expectations at each level (NHS only). A structured framework outlining the expected competencies required for managers and leaders at different stages. The standards address recommendations from NHS leadership reviews around the absence of NHS-wide consistent leadership and management standards, competencies and quality-assured development opportunities.

Self-Assessment tool: Helps leaders and managers to self-assess their capability against the standards and competencies at each stage.

Key messages – NHS leadership and management framework

The NHS Leadership and Management Framework is a new national initiative which will consistently support managers at all levels to improve their working practices and improve standards across the system.
For the first time in its history, the NHS now has a single national framework to support all leaders and managers, both clinical and non-clinical at every level, to meet set required standards.
To deliver the ambitions set out in the 10 Year Health Plan we must ensure the NHS has leaders and managers who are confident, capable, and future-focused to respond to the evolving needs of staff, patients, and communities.
System integration, the move from hospital-centred to community-based care requires leaders and managers who can work across traditional boundaries, coordinate between different care settings, and develop new neighbourhood health services.
Leaders and managers can now use a transparent and consistent set of national standards that defines what good looks like at every level and feel supported in meeting them.
The NHS Leadership and Management Framework will enable leaders and managers to develop with ambition and help staff to focus on what matters most: better care for patients and communities.
To help embed the framework, colleagues will have access to a self-assessment tool enabling evaluation against the expected standard of managers. This will support a clearer understanding of strengths and development areas ahead of appraisals.
The framework will form the backbone of the NHS College of Leadership and Management, providing a consistent foundation for leadership and management development across the NHS.
By supporting high-quality development and diverse talent pipelines into senior leadership and executive roles, the college will help ensure the NHS has the skills, behaviours and capabilities needed to improve patient outcomes.
The NHS Leadership and Management Framework has been co-developed with NHS managers, leaders and patient representatives, alongside key partners including the Chartered Management Institute, Faculty of Medical Leadership and Management and Florence Nightingale Foundation.