In introducing Government plans for a consultation on the regulation of NHS managers we were told:
The Secretary of State pledges to hold NHS managers accountable, and ban those who commit serious misconduct
Regulation will bring in professional standards and support a culture of transparency
Proposals will ensure patient safety is at the heart of leadership in an NHS fit for the future.
further work is being undertaken by NHS England to develop professional standards for managers, which could form the foundations for future regulatory standards for managers.
Any serious consultation on the regulation of managers and leaders in the NHS
needs to be clear what the problem is that needs to be solved;
needs to understand what effective leadership looks like in the NHS (and what it doesn’t look like);
needs to explain why whatever form of regulation is proposed will actually address current shortcomings and better enable more effective NHS management and leadership.
It also needs to clarify the relationship between the standards set for the Fit and Proper Persons Framework for Board directors and standards set for managers generally within the proposed Code of Practice for NHS managers.
After discussion with a number of colleagues I have drafted a contribution to the consultation which I suspect challenges a number of the assumptions being made by other submissions. It can be found below.
The standards that the NHS and its managers and leaders should seek to uphold should include behavioural standards and
ensure managers are supported to do their very best in whatever role they work;
clarify which standards, should they be breached, might lead to adverse consequences for individual managers and leaders
High profile miscarriages of justice revealed by the Michelle Cox case and the Susan Gilbey case are the tip of a much more extensive pattern of toxic behaviours and failed governance that the NHS has failed to address. There may well be a role for a Code for Managers but we do not need one that is performative and neither provides clarity for managers, support for them or accountability for poor behaviours.
This submission is intended as a contribution to the consultation but also a challenge to any proposals that fail to make a serious contribution to a problem that is in plain sight across the NHS. It includes:
a suggested set of principles to underpin any Code balancing support and accountability
examples of what I term “never events” that should invite sanction
a draft alternative Code to the one that is currently circulating
Please read and share it if you think is will prompt helpful discussion.
Read my full response to the Department of Health and Social Care
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