Managers face legal penalties for failing to deal with safety concerns
NHS managers would be made “legally accountable for responding to concerns about patient safety” under new government proposals.
Health and social care secretary Wes Streeting said his department would begin consulting on “new protections for whistleblowers” on Tuesday.
Proposals will include “a statutory duty of candour which would make NHS managers legally accountable for responding to concerns about patient safety”.
At present the “duty of candour” in the NHS applies to organisations, not individuals, and only organisations can be prosecuted for failures. It applies to organisations registered with the Care Quality Commission — so excludes integrated care boards and NHS England, for example.
Earlier this year, government said it would create a new statutory duty of candour for senior “public servants” under the proposed Hillsborough Law, but it has previously refused to say if this would include NHS leaders.
Recommendations from the infected blood inquiry, which reported in May, were for the service to roll out a statutory duty of candour for individuals in leadership positions across the NHS — particularly executives and board members.
In Sunday’s announcement, the Department of Health and Social Care said its proposed new rules — which also include manager regulation (see below) — would apply “at a minimum” to “all board-level directors, integrated care board members, and arms-length body board directors”.
If the professional duty of candour is applied to arms-length bodies, such as NHSE and the CQC, this will also be the first time they are covered by a duty of candour.
On Tuesday, DHSC will provide more details of the proposals and publish the report of a “call for evidence” on the duty of candour, which launched in December 2023.
Regulation of managers
It will also on Tuesday begin a 12-week consultation on how to regulate NHS managers, which it said would prevent a “revolving door” allowing individuals to continue to work even after major failures.
A statement on Sunday said the consultation will consider the options of: a voluntary accreditation register, statutory barring mechanisms and full statutory registration.
Mr Streeting said last year he supported regulation of managers, in the wake of the conviction of Lucy Letby for murdering babies, where there have been allegations that executives did not act quickly enough on doctors’ concerns. The Labour manifesto promised to introduce “professional standards and regulate NHS managers, ensuring those who commit serious misconduct can never do so again”.
Last week the public inquiry into Letby’s murders at the Countess of Chester Hospital former NHS regional director told how she was in autumn 2018 asked to “rehabilitate” its CEO after he had fallen out with its board and paediatricians, by finding him a temporary senior management role. He later worked as interim CEO of three trusts, in the period before Letby was convicted.
This week the inquiry is due to hear from the CEO, Tony Chambers, as well as the nursing and medical directors at the time of the babies’ deaths.
Health minister Karin Smyth, a former NHS manager, said: “To turn around our NHS we need the best and brightest managing the health service, a culture of transparency that keeps patients safe, and an end to the revolving door that allows failed managers to pick up in a new NHS organisation.”
NHSE chief executive Amanda Pritchard said it was “critical” regulation of managers comes alongside support and development, and highlighted NHSE’s work to develop this.
NHS Providers’ interim chief executive Saffron Cordery said regulation should be “fair and equitable” and “independent of both those being regulated, and of politics”.
NHS Confederation deputy CEO Danny Mortimer said there must be “investigation against clear standards of professional conduct” and said: “We must all ensure that problems of discrimination encountered elsewhere are not replicated.”