NHS Consultant Values-Based Interviews

• Values-based interviews are not primarily a test of whether you can remember the trust's values. They explore whether your previous behaviour and the way you approach difficult situations are consistent with those values.
• Different NHS organisations use different terminology, but most trust values can be grouped into a relatively small number of recurring themes. Understanding the behaviours behind them is therefore more useful than memorising individual words.
• At consultant level, panels are particularly interested in judgement. Compassion does not mean avoiding accountability. Respect does not mean avoiding disagreement. Putting patients first does not mean agreeing to everything a patient requests. Speaking up does not mean formally escalating every difference of opinion.
• STAR can provide a useful structure for values-based examples, but the strongest consultant answers go beyond a simple description of what happened. They explain your reasoning, the competing considerations you recognised and what you subsequently learnt.
• You do not need a separate prepared example for every possible NHS value. A small number of sufficiently rich experiences can usually be explored from several different values-based perspectives.

A values-based interview explores whether the way you behave is consistent with the values and culture of the organisation appointing you. Rather than simply asking whether you believe in compassion, respect or teamwork, the panel looks for evidence of how those principles have influenced your behaviour in real situations. A candidate could quite reasonably say: “I believe strongly in treating everybody with respect”. There is nothing wrong with the statement, but it provides very little evidence.

A panel is likely to learn considerably more by asking: “Tell us about a time when you had to challenge the behaviour of a colleague”. This question forces you to demonstrate what respect, professionalism and leadership actually mean when maintaining them requires judgement and effort.

This becomes particularly important at consultant level. Consultants do not simply work within the culture of a department; they help create it. The way you respond to mistakes, disagreement, pressure and poor behaviour influences trainees, nurses, allied health professionals, administrative staff and other consultants. The panel is therefore considering not only whether you personally behave appropriately, but what kind of influence you are likely to have on the wider team.

One of the difficulties with preparing for a values-based interview is the sheer variety of language used across the NHS. One trust may talk about kindness, another compassion or caring. Elsewhere you will find values such as respect, inclusion, excellence, ambition, innovation, integrity, accountability and empowerment. It can therefore look as though every organisation has developed a completely different set of expectations. In reality, there is considerable overlap.

The NHS Constitution provides the broad foundation through six values:

• Working together for patients
• Respect and dignity
• Commitment to quality of care
• Compassion
• Improving lives
• Everyone counts

Individual NHS organisations then develop their own local values and behavioural frameworks around these principles.

The terminology can vary considerably. For example:

• King's College Hospital uses Caring, Collaborative, Inclusive and Innovative.
• Cambridge University Hospitals uses Safe, Kind and Excellent.
• Newcastle Hospitals uses Kind, Respectful and Inclusive Team
• Central London Community Healthcare uses Accountability, Inclusion, Compassion and Empowerment.

For interview purposes, however, most of the values you are likely to encounter can usefully be grouped into around 15 broad themes. These are not intended to replace the particular values of the organisation you are applying to. If your prospective trust talks about kindness, use its terminology rather than deciding that compassion means roughly the same thing.

The purpose of the framework is to help you get underneath the word itself. Once you understand the behaviours associated with these broad themes, it becomes much easier to work out what an unfamiliar trust value is actually asking of you.

Compassion is sometimes interpreted rather superficially at interview. Candidates talk about being kind, listening to patients and treating people with empathy. All of these are important, but at consultant level the panel will usually be interested in how compassion affects your behaviour when a situation becomes more complicated.

A compassionate consultant notices what may be happening beneath the surface. The angry patient may actually be frightened. The trainee whose performance has deteriorated may be struggling outside work. The colleague who has become unusually irritable may be exhausted or overwhelmed.

Recognising this does not mean that poor performance or inappropriate behaviour should be excused. Compassion and accountability are not opposites. You may need to have a difficult conversation with somebody while still making an effort to understand what has contributed to the situation.

Respect is relatively easy to demonstrate when everyone agrees. It becomes much more meaningful when there is disagreement, frustration or a significant difference in status. At consultant level, respect includes the way you use authority. It means listening properly to other people's concerns, acknowledging expertise in others and disagreeing without belittling them. It also requires awareness of hierarchy. A junior colleague may technically be able to disagree with you without necessarily feeling able to do so.

Modern healthcare is too complex for a consultant to work effectively in isolation. Collaboration is therefore about considerably more than attending MDT meetings and describing yourself as a team player.

A collaborative consultant recognises that expertise is distributed across the team. They seek other perspectives, share information, ask for help when necessary and are prepared to alter their own view when somebody else brings important information to the discussion.

Good collaboration is particularly visible during disagreement. A consultant who works well with others should be able to challenge another professional without making the disagreement personal and recognise when another person's argument is stronger than their own.

Inclusion is sometimes reduced to saying that everybody should be treated equally. The difficulty is that treating everybody identically does not necessarily produce equitable care or an inclusive working environment.

For patients, inclusion means thinking about the barriers that may prevent somebody from participating fully in their care. Language, disability, culture, health literacy and socioeconomic circumstances can all affect a person's ability to access services or participate in decision-making.

For staff, it includes noticing who is heard and who is not. A consultant has considerable influence over whether a team develops a culture in which only the most confident voices are heard.

Few candidates would disagree with the principle that patients should come first. The more difficult question is what that means when the patient's preferences, the available evidence and the constraints of the healthcare system do not align perfectly.

Patient-centred care begins with understanding what matters to the individual. It means explaining options honestly, checking understanding, involving relatives or carers appropriately and making decisions with patients rather than simply for them.

Patient-centred care begins with understanding what matters to the individual. It means explaining options honestly, checking understanding, involving relatives or carers appropriately and making decisions with patients rather than simply for them. It does not mean agreeing to every request. A patient may want an investigation or treatment that is unlikely to benefit them. A consultant may have to explain why something is not appropriate while still taking the patient's concerns seriously.

Safety involves considerably more than complying with protocols. Consultants need to recognise risk, respond appropriately to harm and notice warning signs before an incident occurs. It also involves psychological safety. A technically excellent department can still be unsafe if junior members of staff are reluctant to ask for help or challenge senior decisions.

There is an important distinction between making the immediate situation safe and understanding why it arose. A consultant may need to deal with the immediate clinical risk, but good safety leadership also asks what needs to change to make recurrence less likely.

Words such as excellence can become meaningless unless they are translated into behaviour. In practice, they usually describe an unwillingness to become complacent about the standard of care.

A consultant demonstrating this value uses evidence rather than relying solely on established custom. They monitor outcomes, investigate unwarranted variation, respond to complaints and feedback, and compare the service against appropriate standards.

Maintaining standards becomes particularly important when the service is under pressure. The more difficult judgement is deciding which standards are genuinely non-negotiable and where processes can safely be adapted.

Improvement is closely related to excellence, but there is an important distinction. Excellence concerns the standard you are trying to achieve; improvement concerns what you do when you recognise that things could be better.

A consultant with a learning mindset seeks feedback, examines outcomes and is prepared to change established practice. They learn from incidents and complaints rather than treating them simply as events that need to be closed. They are interested in why systems behave as they do and recognise that an error by an individual may reveal a wider problem.

Innovation should not be confused with novelty. The purpose is not to introduce something new simply because it is new, but to find better ways of solving genuine problems. At consultant level, innovation should also be accompanied by evaluation. What problem are you trying to solve? What evidence supports the proposed solution? How will you know whether it has worked? What might the unintended consequences be? A mature consultant should also be prepared to modify or abandon an idea when the evidence does not support it.

Integrity becomes particularly visible when honesty carries a cost. Most people find it relatively easy to be open when everything has gone well. The test comes when something has gone wrong, when you are uncertain, when you have made the mistake yourself or when acknowledging the truth may be professionally uncomfortable.

For a consultant, integrity includes acknowledging mistakes, being candid with patients, declaring conflicts of interest and being honest about uncertainty. It also means not presenting information selectively simply because the complete picture is uncomfortable.

Healthcare organisations are complex, and it is often possible to explain why a particular problem technically belongs to somebody else. Accountability means recognising when that answer is not sufficient.

This does not mean that consultants should attempt to solve every problem themselves. Good leadership includes understanding the boundaries of your authority and knowing when something needs to be passed to somebody better placed to deal with it.

What matters is ownership and follow-through. If you identify an important problem, do you simply send an email and regard your responsibility as complete, or do you ensure that it has actually reached somebody capable of acting?

Not every trust uses courage as an explicit value, but the behaviour sits underneath many values frameworks. Speaking up becomes meaningful precisely because there are circumstances in which remaining silent would be easier. A consultant may need to challenge an unsafe decision, question a respected colleague, raise concerns about culture or support a junior member of staff who has reported inappropriate behaviour.

Courage also requires judgement. Escalating every disagreement formally is not necessarily evidence of strong leadership. Sometimes a direct conversation is entirely appropriate; at other times the seriousness of the problem requires formal escalation.

Good consultant leadership should develop capability in other people rather than create unnecessary dependence on the consultant. This involves giving people appropriate responsibility, providing support, offering useful feedback and gradually allowing greater autonomy as competence and confidence develop.

With patients, empowerment means giving people sufficient information and support to participate meaningfully in decisions rather than simply providing information and assuming that this constitutes shared decision-making.

Professionalism is demonstrated most clearly when circumstances are difficult. It includes reliability, appropriate boundaries, confidentiality, communication, self-awareness and the ability to regulate your own behaviour under pressure.

Seniority increases the importance of this because the consultant's mood and behaviour can have a disproportionate effect on the rest of the team.

Consultants are human and will experience frustration, anxiety and anger. Professionalism does not require the absence of those emotions, but it does require an awareness of how they affect other people.

Consultants have responsibilities to the wider population as well as to individual patients. The NHS does not have unlimited resources, and decisions about investigations, treatments, theatre time, clinic capacity and workforce inevitably affect other people.

Responsible stewardship does not mean allowing financial considerations to override clinical need. It means recognising that unnecessary or low-value activity also has consequences for patients.

This can create genuine tension with patient-centred care. A patient may request an intervention that has very limited evidence of benefit. A consultant needs to consider the individual compassionately while also recognising that resources committed in one place are unavailable elsewhere.

These 15 categories should not be thought of as separate boxes. In real clinical practice, the same situation will often involve several values at once.

Imagine that several junior doctors tell you that they have become reluctant to telephone a particular consultant because of the way that consultant responds to them.

There is an obvious issue of respect, but there is much more happening. Compassion requires you to recognise the impact on the junior doctors. Safety becomes relevant because reluctance to seek senior advice could affect patients. Inclusion means taking the views of relatively junior members of staff seriously despite the hierarchy. Courage may be required to raise the issue with a respected colleague, while professionalism influences how you conduct that conversation.

Accountability means not simply deciding that somebody else should deal with it. Improvement requires you to consider whether there are wider system factors contributing to the problem. Integrity means being willing to acknowledge that there is a problem even if the consultant concerned is popular, influential or somebody you personally like.

This is much closer to the reality of consultant practice than treating every value independently.

One of the most useful consequences of understanding the overlap between NHS values is that you do not need to prepare a separate story for every possible value. In most cases, six to eight sufficiently rich experiences will give you considerably better preparation than 15 rehearsed answers.

You might prepare an example involving a colleague whose behaviour you challenged, somebody you supported through difficulty, a disagreement within an MDT, a patient whose wishes were difficult to reconcile with the clinical situation, something that went wrong, an inequality you recognised, an improvement you led and an occasion when you received difficult feedback yourself.

The same experience can legitimately answer several different questions.

Consider a complaint. If the panel asks about compassion, you might concentrate on how you understood the patient's or family's experience. If they ask about openness, you might focus on the conversations that followed and how you approached candour. If they ask about improvement, the important part of the story may be what you changed afterwards. If they ask about accountability, you might explore how you took ownership even though several people or departments were involved.

The event has not changed. What changes is the aspect of your behaviour that you are being asked to examine.

Values are easy to claim when nothing is at stake. Almost everybody believes in compassion, supports patient-centred care and considers teamwork important. The more revealing situations are those in which two legitimate principles pull in different directions.

Compassion may conflict with accountability. Patient choice may conflict with safety. Respect for a colleague may conflict with the need to challenge their behaviour. Team harmony may conflict with speaking up. Openness may cause reputational discomfort. Innovation may introduce new risks. The needs of one patient may compete with the needs of many others.

These are often the richest experiences to discuss at a consultant interview because there is no simple phrase or algorithm that provides the answer. They require judgement.

A values-based interview is therefore not really asking whether you possess a collection of desirable personal qualities. It is exploring what happens to those principles when applying them becomes difficult.

STAR remains a useful framework for answering questions about previous experiences: Situation – Task – Action – Result.

For consultant interviews, however, we would usually add another component: Reflection.

The framework prevents two common problems. Some candidates spend so long explaining the background that the panel never really discovers what they did. Others jump immediately into a list of actions without giving enough context to explain why those actions required judgement.

The greater danger is turning STAR into a formula. At consultant level, the panel is not simply interested in whether you can describe a logical sequence of events. It wants to understand how you thought.

Situation: Establish briefly what was happening, who was involved and why the situation mattered. Candidates often spend too long here because the background is vivid in their own memory. The panel generally needs much less information than you think.

Task: Explain your responsibility within the situation. What were you trying to achieve, and why was it your responsibility to become involved?

Action: This should usually be the most substantial part of the answer. At consultant level, simply listing what you did is not enough. Explain what you noticed, what alternatives you considered, why you chose one approach rather than another and how you adapted your behaviour as the situation developed.
This is also where the competing values frequently become apparent. You may have been trying to support somebody while holding them accountable, respect a patient's autonomy while preventing harm, or challenge a colleague without unnecessarily damaging the relationship.

Result: Explain what happened. The outcome does not need to be an implausibly perfect success. A credible partial improvement is often much more convincing than a story in which every problem disappears.

Reflection: Finally, explain what you learnt and whether the experience changed anything about your subsequent practice.
Reflection turns a story about something that happened into evidence of your development as a consultant.

The following three examples show how several values can operate within the same experience.

Question: “Tell us about a time when you had to challenge the behaviour of a colleague.”

Situation

• You became aware that an experienced colleague had developed a reputation among junior doctors for being abrupt and difficult to approach. There had been no formal complaint and you had not personally witnessed serious misconduct, but several trainees had independently described feeling reluctant to contact the colleague for advice.
• That concerned you because this was no longer simply a question of interpersonal style. If junior doctors were hesitating before escalating clinical concerns, there was a potential patient-safety implication.

Task

• Your responsibility was not simply to confront the colleague. You needed to establish what was actually happening, support the junior doctors, remain fair to the colleague concerned and decide whether the situation required informal intervention or formal escalation.
• You also needed to avoid two opposite errors: dismissing genuine concerns as a personality clash, or prematurely labelling demanding or direct behaviour as bullying without establishing the facts.

Action

• You initially spoke individually with the junior doctors who had raised concerns and asked for specific examples. You deliberately avoided leading questions and tried to understand whether this was an isolated communication problem or a consistent pattern.
• You also explained that you could not promise absolute confidentiality before understanding the seriousness of what was being disclosed. If there were allegations of bullying, discrimination, harassment or an immediate patient-safety risk, the situation might require formal action.
• Once you were satisfied that there was a genuine pattern worth addressing, you spoke privately with the colleague. Rather than telling them that “the juniors think you are rude”, you described the impact you were concerned about: several trainees appeared increasingly reluctant to approach them for advice.
• You also listened to their perspective. It became apparent that they had been working under considerable pressure and were increasingly frustrated by what they regarded as inappropriate referrals and repeated calls about relatively routine problems.
• You acknowledged that frustration without allowing it to excuse the impact of their behaviour.
• The discussion also prompted you to look at the system. Some junior doctors were genuinely unclear about escalation arrangements, and workload was contributing to the colleague's frustration. You therefore addressed both aspects: expectations around escalation were clarified, while the colleague agreed to be more conscious of how they responded when approached.
• At that stage you considered an informal intervention proportionate because there was no evidence of serious misconduct or immediate harm. However, you were clear that persistent behaviour, bullying, discrimination or patient-safety concerns would require formal escalation.
• Most importantly, you followed the situation up rather than assuming that one conversation had solved it.

Result

• Subsequent feedback suggested that the colleague became noticeably more approachable. Clarifying escalation arrangements also reduced some of the inappropriate calls that had contributed to the original frustration.
• The problem therefore had both a behavioural and a system component. Addressing only one would probably have produced a less satisfactory result.

Reflection

• The experience reinforced that compassion and accountability are not alternatives. Understanding why somebody is behaving badly does not require you to accept the effect of that behaviour on others.
• It also made you more conscious of psychological safety. A department can have formal escalation policies and still be unsafe if junior staff are reluctant to use them because of how they expect senior colleagues to respond.

This example contains

• compassion, respect
• safety
• courage
• accountability
• professionalism
• improvement.

The emphasis would change according to the question. If you were asked about compassion, you would concentrate more on understanding the pressures affecting both sides. For speaking up, the decision to challenge the colleague would come to the foreground. For patient safety, you would emphasise the consequences of junior doctors becoming reluctant to escalate.

The experience remains the same; the lens through which you discuss it changes.

Question: “Tell us about a time when a patient's wishes conflicted with what you believed was clinically appropriate.”

Situation

• You were caring for a patient with a serious condition who strongly wanted an intervention that the MDT felt was unlikely to provide meaningful benefit and carried a significant risk of harm.
• The patient and family had interpreted the fact that the intervention was technically possible as meaning that it represented another realistic treatment option. They felt that the team was “giving up”.

Task

• Your responsibility was to reach a clinically appropriate decision while ensuring that the patient remained genuinely involved in it.
• The challenge was not simply to explain why the answer was no. You needed to understand what the patient hoped the intervention would achieve, ensure that they had received accurate information and avoid allowing professional certainty to become paternalism.
• At the same time, respecting patient autonomy did not require you to provide treatment that you believed would be ineffective or harmful.

Action

• You arranged a further conversation rather than attempting to resolve the disagreement during a rushed clinical encounter.
• You began by asking the patient and family what they understood about the situation and what they hoped the proposed intervention would achieve. This revealed that some of the conflict arose from a misunderstanding: they believed that declining the intervention meant that active care would stop altogether.
• You clarified the prognosis and the likely benefits and burdens of the intervention in straightforward language, checking understanding as you went. You acknowledged the uncertainty that genuinely existed rather than presenting the medical view as more certain than it was.
• You also explored what mattered most to the patient. Their principal concern was not necessarily prolonging life at any cost, as the team had initially assumed, but remaining well enough to attend an important family event and spending meaningful time at home.
• That changed the nature of the discussion.
• You reviewed the case again with relevant MDT colleagues to ensure that the recommendation remained sound and that reasonable alternatives had not been overlooked. You then worked with the patient and family on a plan that was more closely aligned with the patient's actual priorities.
• You remained clear that you could not recommend an intervention that you believed was more likely to cause harm than benefit, but the conversation moved away from a confrontation over a particular treatment towards a shared discussion about what the patient was trying to achieve.

Result

• The patient ultimately accepted the recommended approach. More importantly, they did not experience the decision simply as treatment being withdrawn from them.
• The revised plan concentrated on symptom control, maintaining function and maximising time outside hospital, which was much closer to what the patient actually valued.

Reflection

• The experience reinforced the importance of exploring the concern underneath a patient's stated request. What initially appeared to be a disagreement about treatment was partly a disagreement about goals and partly a failure of communication.
• It also reminded you that patient-centred care is not synonymous with giving patients whatever they request. Sometimes it means having a difficult conversation honestly and compassionately while ensuring that their priorities genuinely influence the plan.

Which values are demonstrated?

This example combines

• patient-centredness
• compassion
• respect and dignity
• integrity
• quality
• safety
• teamwork.

For a question about integrity, you might concentrate on honesty about prognosis and uncertainty. For patient-centredness, you would emphasise discovering what mattered to the patient. For teamwork, the process through which the MDT reached and reviewed its recommendation would receive more attention.

Again, the same experience can provide evidence of several values without becoming a generic answer.

Question: “Tell us about a time when you identified a problem with the quality of a service and what you did about it.”

Situation

• You noticed a recurring problem within your service. Several incidents had occurred over a period of time involving delays at the same point in a clinical pathway. None had individually resulted in catastrophic harm, and each had previously been reviewed and closed with actions recorded as completed.
• However, when you looked across the incidents rather than at each one separately, the underlying pattern appeared remarkably similar.

Task

• Your responsibility was to understand why the problem was recurring despite previous investigations and to reduce the risk of further incidents.
• The difficulty was that the service was already under considerable operational pressure. There was little enthusiasm for another investigation, particularly because previous action plans appeared to show that the problem had already been addressed.

Action

• You began by reviewing the incidents together rather than treating them as unrelated events. You examined the previous recommendations and asked whether the actions had merely been completed administratively or whether anybody had assessed whether they had actually changed the system.
• This revealed that several previous actions had concentrated on reminding individual staff about procedures and circulating guidance. The actions had been completed, but the underlying process remained dependent on people remembering to compensate for a poorly designed system.
• Rather than producing another similar action plan, you brought together the relevant clinical and operational staff and mapped the pathway. You deliberately included people who worked within the process every day rather than restricting the discussion to senior clinicians and managers.
• This identified several contributory factors, including an ambiguous handover point, unclear ownership at particular times of day and a communication process that worked reasonably well during normal hours but was much less reliable when staffing was reduced.
• You worked with the team to redesign that part of the pathway, clarify responsibility and introduce a more reliable escalation process.
• You also agreed in advance how the change would be evaluated. Rather than assuming implementation equalled success, you monitored whether delays actually reduced and sought feedback from the staff using the revised process.
• When early data showed that one part of the redesign was creating an unintended bottleneck elsewhere, you modified the process rather than defending the original solution.

Result

• The frequency of delays fell, and staff reported greater clarity about responsibility and escalation.
• Just as importantly, the exercise changed the way similar incidents were subsequently discussed within the service. The question became less about whether an action had been completed and more about whether it had actually reduced the risk.

Reflection

• The experience changed your view of action plans. An action can be technically completed without producing any meaningful improvement.
• It also reinforced the importance of looking for patterns across incidents. When the same problem recurs despite repeated reminders or retraining, the issue may lie less with individual compliance and more with the design of the system.
• Finally, it reminded you that improvement requires some humility. The first solution is not necessarily the right one, and discovering that an intervention has produced an unintended consequence should prompt adaptation rather than defensiveness.

Which values are demonstrated?

This example most obviously demonstrates:

• Quality
• improvement and safety
• accountability
• teamwork
• inclusion
• innovation
• integrity and professionalism.

Accountability is demonstrated by refusing to regard a closed action plan as the end of the matter. Teamwork and inclusion appear in involving the people who actually work within the pathway. Innovation lies in redesigning the process rather than repeating the same intervention, while integrity requires acknowledging that previous actions had not solved the problem.

These examples illustrate why preparing one story for every trust value is rarely the best approach.

The first could answer questions about respect, compassion, speaking up, safety, leadership or accountability. The second could be used for patient-centredness, integrity, compassion, teamwork or difficult communication. The third could support questions about improvement, excellence, safety, innovation, accountability or collaborative leadership.

This does not mean that the same three stories should be forced into every question. Candidates who repeatedly return to one favourite example can appear over-rehearsed and may leave the panel wondering about the breadth of their experience.

The better approach is to prepare a bank of perhaps six to eight substantial experiences, each containing enough complexity to be viewed from more than one perspective. For each experience, think about the different values involved, but also where those values came into tension. In the first example, compassion towards the colleague could potentially have made accountability more difficult. In the second, respect for patient autonomy had to coexist with professional responsibility not to recommend harmful treatment. In the third, the reassuring fact that previous actions had been “completed” had to give way to the more uncomfortable recognition that they had not actually solved the problem.

That is usually where the substance of a consultant-level values answer lies.

STAR is a framework rather than a formula. If every answer begins with “The situation was… My task was… The action I took was…”, the interview can quickly sound mechanical.

Use the framework mentally to make sure your answer has shape, but speak naturally. You might simply begin, “One example that comes to mind was when…” and allow the story to develop. The panel does not need to hear the framework. It needs to hear the evidence and understand your reasoning.

Do not restrict yourself to situations in which you behaved perfectly. Some of the strongest examples involve genuine difficulty. Perhaps you initially misunderstood somebody's behaviour. Perhaps your first intervention did not work. You may have had to challenge somebody more senior, received feedback that was uncomfortable to hear or realised afterwards that you could have handled part of the situation differently.

These examples give you something meaningful to reflect upon. By contrast, stories in which you immediately identified the correct course of action, handled everything flawlessly and were subsequently congratulated by everyone involved can sound rehearsed and provide relatively little insight.

Panels are not generally looking for evidence that you have never made a mistake. They are looking for evidence that you can recognise complexity, exercise judgement and learn.

One of the more revealing values-based questions is: “Tell us about a time when your own behaviour did not reflect your values.”

Candidates often struggle with this because their instinct is to protect themselves. However, a thoughtful answer can demonstrate considerable maturity.

Perhaps you were more abrupt than you realised during a stressful shift. Perhaps you dismissed somebody's concern too quickly. You may have failed initially to recognise how hierarchy affected a conversation, or delivered feedback that was technically justified but poorly judged.

The important thing is not to manufacture a trivial weakness. Explain what happened, how you recognised the impact, what responsibility you took and whether anything subsequently changed in the way you practise.

Values are not demonstrated by never getting anything wrong. They are also demonstrated by what you do when you realise that you have.

At consultant level, many values questions contain an implicit power dimension. A consultant has considerable formal and informal authority. A brief comment from a consultant may therefore carry much more weight than the consultant realises.

A junior doctor may technically be able to challenge you but still find doing so extremely difficult. A nurse may have raised the same concern several times before finally approaching you. A patient may appear to agree with a treatment plan because they do not feel confident enough to question it.

Strong candidates recognise this.

When discussing leadership, speaking up, respect or inclusion, consider the environment you create around yourself. Can people disagree with you? What happens when somebody tells you that you are wrong? Are quieter members of the team heard? How do you react when somebody raises an inconvenient concern?

Those behaviours tell a panel considerably more about your values than simply listing them.

Not every values question will ask about something that has already happened. You may instead be given a hypothetical scenario.

For example: “A junior doctor tells you that another consultant repeatedly belittles them during ward rounds but asks you not to tell anyone. What would you do?”

A strong answer needs to balance several considerations.

You would want to listen carefully and understand what has happened rather than immediately applying a label. You would explore the impact on the junior doctor and establish whether there were concerns about patient safety, bullying, discrimination or harassment.

You would also need to be honest about confidentiality. It may be possible to respect the doctor's wishes to a considerable extent, but you should not promise absolute confidentiality before understanding the seriousness of what is being disclosed. The junior doctor may need support, and you should involve them as far as possible in considering the options. Depending on the circumstances, these might include an informal conversation, educational or supervisory routes, Freedom to Speak Up mechanisms, clinical leadership, HR or formal processes.

What you should avoid is simply telling the junior doctor to confront the consultant themselves. There may be circumstances in which a direct conversation is appropriate, but automatically returning responsibility to the more junior person can completely ignore the power imbalance that caused them to seek your help in the first place.

• Reciting the trust values: You should know the organisation's values, but simply repeating them to the panel is not evidence that you live by them. Use the trust's terminology, then demonstrate what it means through your behaviour.
• Giving generic answers: Statements such as “I always treat everybody with respect” or “patients always come first” are difficult for a panel to evaluate. Give them evidence.
• Choosing examples with no tension: If there was never any difficulty, disagreement, uncertainty or competing priority, the example may reveal relatively little about your judgement.
• Making yourself the hero: Be cautious about examples in which everybody else behaved badly and you arrived to solve the problem. Strong answers usually contain some curiosity about why other people behaved as they did and some humility about your own role.
• Escalating everything immediately: Consultants need to understand proportionality. Not every interpersonal difficulty requires a formal process.
• Keeping everything informal: The opposite is equally problematic. Informal resolution should not become an excuse for avoiding escalation when there is serious misconduct, discrimination, bullying, repeated inappropriate behaviour or significant patient-safety risk.
• Forgetting the outcome: Candidates sometimes describe an impressive sequence of actions without explaining what happened afterwards. The panel needs to know whether anything changed.
• Forgetting reflection: At consultant level, reflection is often one of the most interesting parts of the answer. Explain what the experience taught you and whether it changed the way you subsequently practise.

Start with the organisation itself. Read its published values, but do not stop there. Look at the behaviours associated with them and consider how those values appear in the organisation's strategy and culture.

Then build a relatively small bank of genuine experiences from your own career. Six to eight substantial examples are usually more useful than dozens of superficial ones.

Think about situations involving difficult colleagues, supporting somebody who was struggling, receiving challenging feedback, advocating for a patient, managing disagreement, speaking up, improving a service, making a mistake and addressing inequality.

For each example, understand the facts well enough that you can approach it from different angles. What did you notice? What did you decide? Why? What competing considerations were present? What happened? What would you do differently now?

Do not memorise complete scripts. The question you receive on the day may be slightly different from the one you prepared. Candidates who have memorised answers often struggle to adapt them, whereas somebody who understands their examples deeply can use them flexibly.

Use your pre-interview visit to find out what the Trust’s stated values mean in everyday practice.

Do not assume that values will be confined to a question explicitly described as values-based. They may appear in questions about leadership, clinical governance, patient safety, complaints, equality and diversity, difficult colleagues, service pressures, resource allocation, teaching and multidisciplinary working.

For example: “What would you do if a colleague consistently failed to meet an agreed clinical standard?”

This is partly a performance-management question, but it is also about compassion, fairness, accountability, professionalism and patient safety.

Similarly: “How would you deal with disagreement within the MDT?” is a teamwork question, but it also explores respect, inclusion, communication and potentially the courage to challenge.

The strongest consultant candidates therefore do not bolt values onto their answers as an afterthought. Their values become apparent through the way they reason.

For the rest of your preparation, including researching the post and practising answers, see How to Prepare for an NHS Consultant Interview.