Free course · Lesson one open to everyone
The values, structure, funding, and pressures of the NHS, how it compares to other countries' systems, and how to bring genuine knowledge of it into an interview answer rather than a memorised list.
Why examiners test this
Interviewers ask about the NHS Constitution not to check whether you memorised a leaflet, but to see whether you understand what kind of institution you are asking to join. The NHS Constitution for England sets out six values and seven principles. Knowing them by name is the easy part. Being able to use one to reason through a scenario is what actually earns marks.
The six values
As stated in the current NHS Constitution, the six values are: working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts, which is about fairness and reducing inequality in who gets care and how resources are shared.
A patient from a low-income background struggles to attend follow-up appointments due to transport costs, and a clinic considers offering a home-visit alternative. Which NHS value does this decision most directly reflect?
"Everyone counts" is specifically about fairness and reducing inequality in access to care. Compassion is a reasonable secondary link, but the core issue here is unequal access, which is what this value addresses directly.
The seven principles
The principles describe how the NHS operates as a system rather than how individual staff should behave. The two that come up constantly in interview: "access to NHS services is based on clinical need, not an individual's ability to pay," which is the founding idea of the NHS, and "the NHS is committed to providing best value for taxpayers' money," which underpins almost every question about rationing or resource allocation.
The other five principles
The remaining five are worth being able to recognise rather than recite: the NHS provides a comprehensive service, available to all; it aspires to the highest standards of excellence and professionalism; the patient will be at the heart of everything it does; it works across organisational boundaries; and it is accountable to the public, communities, and patients it serves.
The principle "the NHS works across organisational boundaries" is put into practice in England mainly through which structure, covered later in this module?
Integrated Care Systems exist specifically to join up hospitals, GP practices, mental health services, and social care around one population, which is the practical expression of this principle.
An interviewer asks: "A new cancer drug costs £100,000 per patient and extends life by an average of three months. Should the NHS fund it?"
Say yes immediately, since refusing to fund a life-extending drug feels wrong
Worth reconsidering: This avoids the actual tension the question is testing: that funding one expensive treatment means less money for other patients elsewhere in the system.
Explain that this is exactly the kind of decision bodies like NICE exist to make, weighing patient benefit against cost using tools like the QALY, and that funding one treatment has an opportunity cost for other patients
Strong approach: This shows you understand the principle of best value for money is not about denying care out of unkindness, but about making the fairest use of a limited shared resource.
Say cost should never be a factor in medical decisions
Worth reconsidering: This does not reflect how healthcare systems with finite budgets actually have to operate, and ignores that NHS resources spent on one patient are unavailable for others.
Think it through
Which single NHS value or principle do you find easiest to connect to your own work experience or volunteering? Try to think of one specific moment that illustrates it.
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