NHS 6Cs: How to Evidence Care, Compassion, Competence, Communication, Courage and Commitment

**TL;DR.** The 6Cs are Care, Compassion, Competence, Communication, Courage and Commitment. They were defined in the NHS England *Compassion in Practice* strategy in December 2012 and now sit inside almost every NHS person specification as values-based criteria. The way to score on them is never to list them. Each value is evidenced through a specific example — a moment when you spoke up, adapted your communication, or held a colleague accountable. This guide walks through each of the six, gives a worked example for each, and shows you the structure that scores.

You are writing your supporting statement and you have just hit a values criterion. The form says: *Demonstrate how you embody NHS values in your practice.*

The temptation is to write: *I demonstrate Care by always caring for my patients, Compassion by being compassionate, and Communication by communicating clearly.* You have probably read advice that tells you to "weave the 6Cs throughout your statement". You may even have a draft that names each one in turn.

If your statement names the values, you have already lost the marks. Panels score values criteria the way they score every other criterion — looking for specific evidence, not labels. This guide explains where the 6Cs come from, what each one actually requires you to evidence, and exactly how to write a paragraph that scores 4 instead of 1.

Where the 6Cs come from

The 6Cs are not folklore. They were formally defined in Compassion in Practice, the three-year vision and strategy for nursing, midwifery and care staff published by NHS England in December 2012. The strategy was authored by Jane Cummings, then Chief Nursing Officer for England, and Viv Bennett, then Director of Nursing at the Department of Health.

The 6Cs were originally framed as values for nursing and midwifery, but they have since been adopted across NHS recruitment more broadly — including for healthcare assistants, allied health professionals, support staff, and many non-clinical roles. Most NHS person specifications now include at least one values-based criterion, and many trusts use the 6Cs explicitly in shortlisting and interview scoring.

The values themselves are written into the NHS Constitution for England, which sets out the rights, responsibilities and pledges that frame how the NHS operates. Whenever the question on the form is "demonstrate how you embody NHS values", the panel is scoring against the 6Cs and the Constitution values together — and they are scoring for evidence, not labels.

Why listing the 6Cs scores zero

Picture the panel. They have 60 applications in front of them. They have allocated 5 minutes per application. They are scoring against the spec line by line. When they hit your values paragraph, they are looking for moments — events that happened, things you decided, words you said.

If your paragraph reads: *I am committed to Care, Compassion, Competence, Communication, Courage and Commitment in everything I do*, the panel sees a label. Labels are not evidence. The score is 1.

If your paragraph reads: *When I noticed a Band 5 colleague was administering a medication that the patient had a documented allergy to, I stopped the administration and raised it directly with the prescribing doctor. The prescription was changed within the hour and the patient was unharmed*, the panel sees a moment. The score is 4. The paragraph evidenced Courage and Competence and Communication without naming any of them. The panel does not need the labels — they recognise the values when they see them.

The rule is simple: **never name a value. Always show one.**

The six, defined — and how to evidence each

These definitions are taken from the original NHS England Compassion in Practice strategy and from the NHS Professionals 6Cs guide. After each definition, there is one worked example showing what evidence looks like.

Care

*Care is our core business and that of our organisations; and the care we deliver helps the individual person and improves the health of the whole community.*

Care is the value that sounds easiest and is hardest to evidence. Everyone in the NHS thinks they care. The panel is not asking whether you care — they are asking whether you can describe a moment when caring drove a specific decision.

**Worked example (Band 5 Adult Nurse, respiratory ward):** *During a busy night shift, I noticed a 64-year-old patient with COPD was anxious about being alone. He had no visitors and his daughter lived in Australia. After my drug round I spent ten minutes sitting with him, walked him through what would happen if his breathing worsened overnight, and arranged for the bay light to stay dimmed but not off so he could see staff move past. He slept through and his oxygen saturations stayed stable. The next day his daughter rang the ward to thank the team — I had passed the message about her father's anxiety on to the day team in handover.*

This evidences Care because the action was driven by a specific patient need, used a specific intervention, and produced a specific outcome that was verifiable.

Compassion

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

Compassion lives in the small adjustments — the choice of words, the body language, the willingness to slow down. The way to evidence Compassion is to describe a moment when you adjusted your behaviour to honour someone's dignity in a difficult situation.

**Worked example (Band 6 Mental Health Nurse, acute ward):** *A patient with severe psychosis became agitated when staff discussed her care in front of her without involving her. I noticed the pattern across two shifts and raised it in the next MDT. I suggested we use a "patient first" handover format where we addressed the patient by name in the room, asked her how she was feeling, and only afterwards summarised her care plan to the team. The change was adopted across the ward. Two weeks later the patient told me she felt "spoken to, not about", and her engagement with treatment improved measurably.*

The evidence is in the adjustment, not the empathy. Empathy is what triggered the change. The change is what the panel scores.

Competence

*Competence means all those in caring roles must have the ability to understand an individual's health and social needs and have the expertise, clinical and technical knowledge to deliver effective care and treatments based on research and evidence.*

Competence is evidenced by naming a specific skill, framework or piece of knowledge that you applied correctly to a real situation. Vague competence ("I am a competent practitioner") scores 1. Named competence ("I conducted an ABCDE assessment using the Resus Council UK framework") scores 4.

**Worked example (Band 4 Nursing Associate, surgical ward):** *I conducted a structured pre-operative assessment for a patient scheduled for elective hip replacement using the trust's surgical pre-op checklist. I identified that the patient had been incorrectly fasted for 14 hours when the protocol requires 6 hours minimum and 8 hours maximum, and that her blood glucose had dropped to 4.2 mmol/L. I escalated to the registered nurse, the fasting protocol was corrected, and the patient was given a glucose drink before transfer to theatre. I documented the incident on Datix and the surgical induction process was reviewed at the next governance meeting.*

Competence here is evidenced by the named protocol, the named measurement, the correct response, and the systemic follow-up.

Communication

*Communication is central to successful caring relationships and to effective team working. Listening is as important as what we say and do.*

Communication evidence has to show adaptation. Standard handovers and standard charting are not evidence — they are baseline expectation. Evidence is when you adapted your communication to a specific person or situation.

**Worked example (Band 3 Healthcare Assistant, stroke unit):** *A newly admitted patient with expressive aphasia following a left MCA stroke could not respond verbally to our standard fluid balance questions. I worked with the speech and language therapist to adapt our communication: I used a printed picture board with images of cups, jugs and time of day, and confirmed each entry by reading it back and waiting for a thumbs-up. Over the first 48 hours we recorded a complete fluid balance for the first time since admission, and the medical team adjusted his hydration plan based on the data.*

The evidence is the adaptation, the collaboration with another professional, and the measurable outcome.

Courage

*Courage enables us to do the right thing for the people we care for, to speak up when we have concerns and to have the personal strength and vision to innovate and to embrace new ways of working.*

Courage is the value most candidates skip — and it is the most powerful when evidenced well. Panels know that staff who can describe a moment of courage are staff who can be trusted in difficult situations. Skipping Courage is a missed opportunity.

**Worked example (Band 6 Specialist Nurse, acute medical unit):** *When the on-call medical SpR prescribed a 50-unit subcutaneous insulin dose for a patient I knew to be opiate-tolerant and at risk of significant hypoglycaemia, I queried the dose directly with the prescriber before administering it. The conversation was uncomfortable — the SpR initially insisted the dose was correct — but I explained my concern, referenced the patient's prior admission notes, and requested a senior review. The dose was reduced to 14 units and the patient remained euglycaemic.*

Courage in this example is the moment of querying upwards. It is uncomfortable, it is documented, and the outcome is verifiable.

Commitment

*A commitment to our patients and populations is a cornerstone of what we do. We need to build on our commitment to improve the care and experience of our patients.*

Commitment is evidenced over time, not in a single moment. The way to evidence it is to describe sustained involvement in something that goes beyond your job description — a quality improvement project, a teaching role for new starters, an audit, or a sustained piece of advocacy.

**Worked example (Band 7 Ward Manager, elderly care):** *Following a thematic review of three falls incidents on the ward in early 2025, I established a monthly falls huddle with the physiotherapy lead, the pharmacist, and the Band 5 nurse rota leads. The huddle reviewed every fall in the previous month, identified root causes, and agreed targeted interventions — including a revised footwear policy and a re-evaluation of every patient's medication for falls risk. Over six months we reduced reported falls from a monthly average of 7 to a monthly average of 2.*

Commitment is sustained action with measurable outcome. Six months of falls huddles is evidence. "I am committed to patient safety" is not.

Putting it together — one paragraph that evidences three values at once

Strong supporting statements often evidence multiple values within a single paragraph, because real moments are multidimensional. Here is a single Band 5 worked example that evidences Care, Communication, Courage, and Competence simultaneously:

> *On a busy late shift on the acute admissions unit, an 82-year-old man with delirium was becoming distressed and refusing his evening medication. The Band 5 colleague handing over to me had documented him as "non-compliant". I sat with him for ten minutes, used a calm and slow tone of voice, and discovered through gentle questioning that he was confused about where he was — he thought he had been admitted to a residential home and was angry about it. I explained where he was, oriented him to the time and the day, and asked if he would like a family member contacted. He took his medication after the conversation. I also raised in handover that "non-compliant" was an inappropriate documentation term for a patient with delirium, and the ward manager later updated the team on documentation standards.*

That paragraph would score a 4 against any values criterion. It opens with a specific moment, names the actions taken, includes a willingness to challenge a colleague's framing, and produces a measurable outcome. The panel never has to read the words "Care", "Communication", "Courage" or "Competence" to know they are all there.

A pre-submission test for any values paragraph

Before you submit, run each values paragraph through three checks:

1. **Could the panel identify the value without me naming it?** If you removed the words "Care", "Compassion", "Competence", "Communication", "Courage", "Commitment" from the paragraph, would the panel still see the value clearly? If yes, your paragraph is doing its job. If no, you are leaning on labels. 2. **Is there a specific moment, with a date or context that anchors it in time?** "I always show compassion" is not a moment. "On a late shift in March 2025, when an elderly patient became distressed about being alone..." is a moment. 3. **Is there an outcome that someone else could verify?** "He was reassured" is weak. "His oxygen saturations stayed stable through the night and his daughter rang the ward to thank the team" is verifiable.

If a paragraph passes all three tests, it scores. If it fails any, rewrite it.

How SpecMatch handles the 6Cs

The SpecMatch supporting statement generator produces statements that evidence the 6Cs through your real career experience without ever labelling them. It reads your profile, identifies which moments in your career evidence which values, and writes paragraphs that fold the values into specific examples. The 6Cs are never named in the output — only shown.

If you want to score your own statement against the 6Cs after writing it yourself, the Pro plan includes a NHS 6Cs alignment scorer that highlights which values are evidenced and which are missing. Start free without a card.