Ask any UK nurse or healthcare assistant what the “6 Cs” are, and you’ll probably get the full list before their tea’s even brewed: Care, Compassion, Competence, Communication, Courage, Commitment. These aren’t just nice buzzwords stuck on a poster, they’re the backbone of modern NHS care.
The concept came from Jane Cummings, England’s Chief Nursing Officer at the time, as part of the Compassion in Practice strategy launched in late 2012. The mission? Create a clear, shared vision of what great care should look like across nursing, midwifery, and every role that involves looking after people.
The result was a cultural reset. These six values are now baked into everything from clinical training to appraisals to recruitment. They’re the yardstick for what “good care” actually means.
Why the 6 Cs Were Created
The 6 Cs didn’t appear out of nowhere and they weren’t just a nice PR exercise.
They were a direct response to two of the worst care scandals in modern NHS history: the Mid Staffordshire hospital crisis, where hundreds of patients were neglected throughout the mid-to-late 2000s, and the abuse uncovered at Winterbourne View, a private hospital for people with learning disabilities.
Both cases exposed the same brutal truth and horrific failures in the UK healthcare system, that is – when core values are missing, when no one feels responsible, when empathy is absent, when staff feel unsupported – people suffer. Sometimes fatally.
That’s where the 6 Cs come in.
The 6 Cs were designed to unify every patient-facing role behind one common set of principles, from nurses and HCAs to porters and support staff. No matter the uniform or the setting, the 6 Cs offer a shared language for delivering safe, professional, respectful, and genuinely compassionate care.
And as of the 2020s, they’re as relevant now as they were in 2012. Especially now, when services are stretched and staff are burning out. The 6 Cs remind us why we do this in the first place and how to do it right.
So What Are the 6 C’s?
The 6 Cs are intended to guide real decisions within the healthcare sector – shaping behaviour and improving outcomes. Below is a more practical breakdown of what each one really involves in everyday healthcare settings, along with how it links to official NHS guidance.
Care
Care forms the foundation of everything else. It’s not about completing a task list, it’s about consistently delivering the right care, at the right time, for the individual in front of you. That means recognising their needs, preferences, and circumstances, not treating them as a bed number or diagnosis.
NHS England defines care as a value that “underpins the ethos of the NHS,” with every action aimed at improving health and wellbeing, not just treating illness.
Whether it’s respecting personal choices or preserving dignity during basic care, good care should feel personal – because it is.
Compassion
Compassion is often described as “intelligent kindness”, not just feeling sympathy, but expressing it in a way that supports the individual’s experience. It’s about responding to both what a patient says and what they don’t, whether they’re in pain, distressed, or just feeling overlooked.
In practice, this means making time for small gestures that reassure, acknowledging emotional needs as well as physical ones, and treating people as human beings first.
According to Compassion in Practice, compassion should be present in every interaction, especially when patients feel vulnerable or afraid.
Competence
Competence is about having the clinical skills, knowledge, and judgement to carry out your role safely and effectively. It’s not just about what you’ve been taught, but how well you apply it – especially under pressure.
Being competent also means recognising the limits of your own expertise and knowing when to ask for help or escalate concerns.
NHS guidance describes competence as “delivering care based on the best available evidence,” which includes staying up to date with changes in practice and reflecting on your own performance regularly.
Communication
Effective communication is more than passing on information, it’s about making sure everyone involved in care, especially the patient, understands what’s happening and why.
Whether it’s during handovers, care planning, or simply listening well, good communication helps avoid misunderstandings, build trust, and ensure patients feel involved in decisions about their own health.
NHS England highlights that communication “affects every part of the care experience” and is a core component of safety as well as compassion. The principle of “no decision about me, without me” still holds.
Courage
Courage in healthcare doesn’t always look heroic. Sometimes it means raising a concern, questioning unsafe decisions, or backing a patient when they can’t speak up for themselves.
It also means challenging outdated practices, asking for support when needed, and standing by your professional values even when it’s uncomfortable or unpopular.
The 6 Cs framework frames courage as “doing the right thing for the people we care for, speaking up when we have concerns, and having the personal strength and vision to innovate and embrace new ways of working.”
Commitment
Commitment is the thread that ties everything together. It’s about being consistently reliable, focused on improving outcomes, and willing to keep learning throughout your career.
It also means holding yourself to a professional standard – showing up prepared, engaging in reflective practice, and actively contributing to team goals.
In the original Compassion in Practice vision, commitment was described as “a cornerstone of compassionate care,” requiring dedication not just to patients, but to colleagues and continual improvement across the system.
6 Cs in Action: Real‑World Scenarios
While each of the 6 Cs can stand on its own, they’re often most powerful when they work together. Below are three short case-based scenarios where multiple values overlap just as they do on the job.
Scenario 1: Ward Handover
Setting:
Late shift on an acute medical ward.
A senior nurse is handing over to the night team. Among the patients is an elderly gentleman recently admitted following a fall. The nurse makes a point to mention he’s confused and has been removing his oxygen mask, and that his daughter raised concerns about how much he understands.
Values shown:
- Communication – clear, relevant handover that focuses on patient safety and involvement.
- Compassion – acknowledging emotional distress and confusion, not just the clinical details.
- Competence – anticipating risk factors (e.g. potential for wandering or falls) and ensuring continuity of care.
Why it matters:
A handover isn’t just an admin task, it directly affects how well the patient is supported overnight. Taking time to explain the “why” as well as the “what” reflects both care and professionalism.
Scenario 2: Safeguarding Concern
Setting:
Community nurse visiting a housebound patient.
During a routine dressing change, the nurse notices the patient’s fridge is empty and their home is extremely cold. The patient seems withdrawn and mentions they “don’t like to be a bother.” The nurse logs a safeguarding concern and raises it with the adult social care team the same day.
Values shown:
- Courage – recognising that something isn’t right and taking action, even when it involves escalating outside your own team.
- Care – focusing on the patient’s overall wellbeing, not just their wound.
- Communication – sensitively discussing concerns with the patient and coordinating with other professionals.
Why it matters:
Safeguarding isn’t about blame, it’s about acting early. The nurse’s instinct, backed by professional responsibility, helps prevent the patient from slipping through the cracks.
Scenario 3: Patient Advocacy
Setting:
Surgical assessment unit.
A newly qualified nurse notices a patient hasn’t been drinking, despite being nil by mouth for hours longer than necessary. The patient says no one has explained what’s happening. The nurse double-checks the plan, discovers a delay in review, and politely challenges the delay with the registrar, resulting in the patient being seen and updated.
Values shown:
- Commitment – showing dedication to getting things right for the patient, not just following orders.
- Courage – questioning a plan tactfully and constructively.
- Communication – making sure the patient understands what’s happening and feels heard.
Why it matters:
Patient experience isn’t just about procedures, it’s about feeling safe, respected and informed. Speaking up protects both dignity and safety.
Bridging Other Principles
The 6 Cs are closely aligned with other key values and frameworks across UK health and social care. Whether you’re working in a hospital, the community, or a care home setting, these principles underpin most of what high-quality care looks like in practice.
Person-Centred Care
At the very core of modern healthcare is the principle that care should be built around the individual and not just the service. That means recognising patients as partners in their own health journey.
The 6 Cs directly support this:
- Care and Compassion ensure people are treated with dignity and empathy.
- Communication helps patients understand and take part in decisions.
- Commitment and Competence keep care safe and consistent across teams.
This aligns with NHS England’s What Matters to You approach, where professionals are encouraged to ask, listen, and act based on each patient’s preferences and goals.
MECC: Making Every Contact Count
MECC encourages healthcare professionals to use brief interactions to support healthy lifestyle choices, no matter their job title. Whether you’re a nurse, HCA, or allied health professional, the principle is simple: every interaction is an opportunity.
This links closely with:
- Communication – to open up meaningful dialogue.
- Care – to personalise health advice appropriately.
- Commitment – to supporting wider public health goals through day-to-day work.
The 6 Cs help make MECC more than just a box-ticking exercise, they ensure it’s delivered with relevance, sensitivity, and consistency.
NICE Standards and Clinical Governance
The National Institute for Health and Care Excellence (NICE) sets the benchmark for evidence-based, high-quality care across the UK. Their standards reinforce many of the 6 Cs, particularly Competence, Care, and Communication.
Examples include:
- Safeguarding guidelines that promote Courage in reporting concerns.
- Clinical procedures requiring up-to-date knowledge and Competence.
- Quality statements stressing the need for clear, shared decision-making (a key part of Communication).
Following NICE guidance is part of demonstrating professional accountability, and the 6 Cs help embed that accountability in day-to-day practice.
Safeguarding and Duty of Care
Whether working with children or adults, safeguarding is a legal and moral responsibility that connects directly to the 6 Cs.
- Courage is often essential when raising concerns, especially in complex or sensitive situations.
- Care ensures we recognise when something’s wrong, even if it’s not immediately clinical.
- Communication is key to identifying, recording, and escalating issues correctly.
The safeguarding process is not separate from clinical work, it’s embedded in it. The 6 Cs help staff recognise early signs, respond appropriately, and take action with confidence.
Care Planning and Interdisciplinary Working
Good care planning requires collaboration, accurate information sharing, and an understanding of each patient’s specific needs. The 6 Cs support this by:
- Encouraging Competence through accurate assessments.
- Reinforcing Communication across teams and with patients.
- Supporting Commitment to long-term outcomes, not just immediate tasks.
In settings where multiple professionals contribute to care (e.g. GPs, district nurses, social workers), the 6 Cs help ensure the care plan remains person-centred and safe.
Why It Still Matters in 2025
In a healthcare system shaped by change, digital transformation, chronic workforce shortages, shifting patient expectations are all the fundamentals that still matter. The 6 Cs continue to offer clarity and stability because they’re grounded in what care is ultimately about – people.
Healthcare has become faster, more complex, and increasingly data-driven. But for patients and families, the essentials remain the same. They want to be heard, to feel safe, and to know that the people caring for them are doing so with skill, respect, and intent. The 6 Cs provide a shared language that ensures those expectations aren’t lost in the noise.
In 2025, the NHS continues to face unprecedented pressure, from record waiting lists and staffing gaps to the demands of integrating new technologies. There’s more emphasis on productivity, cost-effectiveness, and digital efficiency than ever before. But speed and innovation can’t come at the expense of compassion, dignity, or safety.
The 6 Cs help ensure that whether a patient is being seen by a nurse, an HCA, or through a virtual triage tool, the care they receive is anchored in humanity. They’re as relevant in AI-supported diagnostics as they are in a home visit or a mental health unit.
They also support the people delivering that care. In a system where burnout is high and retention is fragile, having a clear, values-based framework helps remind staff why their role matters and what good care should look and feel like.
In short, the 6 Cs remain essential not in spite of the challenges the NHS faces – but because of them.
