The government has proposed that NHS managers follow the same kind of professional standards as doctors and nurses.
Complaints about managers at the NHS – as opposed to doctors – are legion. As Sandesh Gulhane, Scottish Conservative and Unionist Party’s spokesperson for health and social care, pointed out to Healthcare Today in June: “We could look at virtually every scandal in the NHS, and the pattern is the same: not one manager has ever been held accountable”.
The problem has been that tens of thousands of clinical and non-clinical managers work in the NHS, but there is currently no regulatory framework specifically for managers, like there is for doctors and nurses.
New proposals set out by the Department of Health and Social Care will mean any manager who silences whistleblowers or behaves unacceptably will be banned from returning to a health service position.
“I’m determined to create a culture of honesty and openness in the NHS where whistleblowers are protected, and that demands tough enforcement. If you silence whistleblowers, you will never work in the NHS again. We’ve got to create the conditions where staff are free to come forward and sound the alarm when things go wrong. Protecting the reputation of the NHS should never be put before protecting patient safety,” said Wes Streeting, secretary of state for health and social care.
“I promised no more rewards for failure in the NHS, and these measures will deliver on it. Most NHS leaders are doing a fantastic job, but we need to stop the revolving door that allows managers sacked for misconduct or incompetence to be quietly moved to another well-paid role in another part of the NHS,” he continued.
Overwhelming response
The new proposals were developed following a public consultation launched in November last year. It received more than 4,900 contributions on ways in which managers and leaders could be regulated.
In response, the government said that it intends to ensure that those who have committed serious misconduct are no longer able to work in senior NHS management positions. The statutory barring system will be for board-level directors and their direct reports within NHS bodies.
“Managers will welcome this new regulatory framework, as part of the broader package of actions set out in the plan to attract, develop and retain the best possible leaders for the NHS of today and tomorrow,” said Sam Allen, NHS national director for leadership and management.
Further legislation will set out new statutory powers for the Health and Care Professions Council (HCPC) to disbar NHS leaders in senior roles who have committed serious misconduct. Separate NHS England professional standards for managers will establish a consistent, national set of expectations about NHS management and leadership competency and conduct.
“Along with the ongoing implementation of my other recommendations for improving board competence, this is a positive move to strengthen management in the NHS by weeding out poor leadership. This is good news for whistleblowers and those looking for accountability in senior management, which has long been lacking,” said Tom Kark, author of the Kark Review published in February and which focused on the effectiveness of the Fit and Proper Person Test (FPPT) for NHS board members.
Helping patient safety
Sector responses to the new proposals were positive and focused on the ways that they would improve patient safety.
“The government’s announcement of the introduction of a statutory barring scheme for NHS leaders in senior roles is an important step forward for patient safety,” said Bernie O’Reilly, chief executive and registrar at the Health and Care Professions Council (HCPC), the regulator for a range of health and care professions in the UK.
“As the government’s consultation makes clear, the vast majority of leaders and managers across the NHS work hard every day, making difficult decisions in often challenging circumstances to ensure patients receive safe and effective care. Sadly, there have also been high-profile instances where this has not been the case, and a number of independent reviews have highlighted failures of leadership within the NHS,” he continued.
His comments were echoed by Ben White, Medical Protection Society (MPS) cases team lead, who emphasised that the proposals would improve the safety and quality of patient care.
“Establishing a clear regulatory framework and consistent standards would not only help drive improvement in leadership and management practice but also provide confidence to both patients and healthcare professionals that managers are held to account in a similar way to clinicians,” he said.
