Nursing Interview Hot Topic - The 6 Cs

The 6 Cs were introduced in 2012 to give a general framework to how care in health and social care services should be provided. They were developed and promoted as a response to a number of high-profile cases of poor quality care in health and social care settings. Their purpose was to provide simplified and value-based expectations of those who work and provide health and social care. Since their implementation, they have become heavily interwoven with not just nursing but all clinical and non-clinical staff who work throughout the health and social care stratum. 

So what are they?

Care: This is the key foundation of all health and social care services. Those who access these services should expect a high quality of care. A high level of care can improve health outcomes and public confidence in the system. Service users should expect and receive high-quality care whenever and however they access services. 

Compassion: May also be described as “intelligent kindness” based on providing care that promotes dignity, respect and empathy. It is central to providing individualised, person-centred care, which is positively received by those who access services. 

Competence: Relates to how everyone within health and social care must have the knowledge, training and expertise to provide care which complies with an individual’s health and social needs. Interventions must be effective and based on research and evidence. 

Communication: Covers the communication that must occur between professionals and service users and within a multidisciplinary team. Communication must be effective, timely and appropriate to ensure the best outcomes. Decisions should, wherever possible, be made with the individual’s input in mind; the NHS promotes a ” No decisions without me” attitude. 

Courage: Covers a multitude of important values and practices within health and social care. Practitioners should have the courage to speak out when there is evidence of substandard care or when they recognise a shortcoming of the care being provided. Staff must also have the courage to address shortcomings in their own care or when mistakes are made. Courage to train in and implement new ways of working is also required. 

Commitment: Those in health and social care must be committed to their patients. Both as individuals when giving high-quality care in all situations and to patients as a population through promoting public health. This commitment can be implemented through “Making Every Contact Count”, where health professionals must provide a unified and consistent message of public health promotion in every contact they have with an individual.

1-1 Nursing Interview Tutoring

Includes personalised feedback, regular progress updates and access to 100s of resources

ENQUIRE NOW

The Efficacy of the 6 Cs

Looking at the 6 Cs, they provide a simple framework that individuals can base their care around. Developed after interviews with over 9000 healthcare staff, including nurses, carers and midwives, the 6 Cs tried to highlight the key aspects that should be present in every instance of care. There is debate about whether the 6 Cs are required when the NHS Constitution also provides NHS core values. These values are respect and dignity, quality of care, compassion, improving lives, working together for patients, and everyone counts and were first published in 2009. Equally, nurses and midwives must deliver practice guided by the Nursing and Midwifery Council (NMC) and outlined in The Code handbook. Other health and social care occupations also have professional organisations that provide similar guidance on practice. 

With multiple sources of information to guide good practice, it is often felt instead of clarifying key values; they can confuse priorities. While this can prove difficult in trying to hone and improve practice, it also creates cynicism around these well-meaning initiatives. Many nurses often see the 6 Cs as a “word salad”, a lot of positive-sounding words that only provide an incredibly broad outline of what is good practice. Many argue that if all health and social care professions work to a standardised set of values, then the care should remain consistently high; Sir Robert Francis argued that all NHS staff should work with the same core values at the heart of their practice ‘all staff should be required to commit to abiding by its values and principles.’

Ultimately, the 6 Cs provide a very broad and extremely applicable set of values, to the extent that if you removed them from the context of health and social care, they would be good values for any other profession. That is both to their positive and their detriment. The 6 Cs are incredibly simplified and easy to remember, meaning they can be well advertised, promoted and applied. They are simple to remember and apply to practice and can be used as a loose guide by which to assess care. Conversely, they are an oversimplification of the roles and situations that health and social care staff, including nurses, are part of.

Additionally, values such as compassion and courage are highly subjective and situational. Making them dynamic at that moment and difficult at times to apply. If you were to think of all of the roles and responsibilities of a nurse, could you effectively reduce them to 6 broad principles? It is unlikely, meaning there are gaps and shortcomings in the values of the 6 Cs. 

Ultimately, you don’t need to agree that the 6 Cs are your one source of guidance or, indeed, the most influential in your practice. However, you should know what they are and their role and influence on the care given in health and social care settings.

The 6 Cs in Your Nursing Interview

Questions relating to the 6 Cs may include:

• Can you list the 6Cs?
• Which of the 6Cs do you consider the most important?
• Who should use the 6 Cs as values in their practice?
• How may you apply the 6 Cs to your practice?
• When did the NHS formally introduce the 6Cs?
• Are the 6Cs the only values the NHS has?
• Define what you feel ‘compassion’ means. 
• Tell us about a time that you have shown compassion.
• Why is courage one of the 6Cs?

Answering these questions requires a basic level of knowledge about the 6 Cs and what each means generally. Before going to your nursing interview, think of times you have demonstrated or witnessed each of the 6 Cs and what was positive in that situation. Try to show the interviewers that you can think critically, outline some of the limitations of the 6 Cs and touch on some of the other frameworks staff can base their practice around. 

Check out our other articles on the Nursing Interview for more tips and advice!