NHS managers who silence whistleblowers or endanger patients through misconduct face being sacked and barred from working in the health service for life under radical government plans to regulate thousands of bosses for the first time.
Ministers will begin a public consultation on Tuesday seeking views on the proposals, which they say are designed to eradicate a “culture of cover-up” in the NHS. It follows a series of scandals over the last decade at trusts including Morecambe Bay, East Kent and Shrewsbury and Telford.
A statutory duty of candour making NHS managers legally accountable for responding to concerns about patient safety could also be introduced as part of the government’s plans.
Measures being considered include “statutory barring mechanisms”, similar to systems used for teachers, which could see health bosses who have been deemed to be unfit to practise appearing on a centrally held list.
Tens of thousands of clinical and non-clinical managers work in the NHS but there is no single framework to regulate them in the same way as there is for doctors and nurses. The consultation will run for 12 weeks, after which ministers will consider responses and set out the next steps.
Karin Smyth, a minister in the Department of Health and Social Care, said the proposals formed part of the government’s plans to end the “revolving door” that allows failing bosses to continue working in the NHS.
“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,” she said.
Regulation would prevent the loophole that allows managers with a record of poor performance or misconduct to continue to work in the health service, government sources said.
Options being considered by the consultation include a voluntary accreditation register, statutory barring mechanisms and full statutory registration.
Patients, health and care staff and professional bodies are also being asked for their views on whether to introduce a statutory duty of candour which would make NHS managers legally accountable for responding to concerns about patient safety.
At a minimum, all board-level directors in NHS organisations in England, arm’s length body board level directors and integrated care board members will be regulated under the new system, government sources said.
Amanda Pritchard, the chief executive of NHS England, said it was right that managers faced the same level of accountability as other staff, but it was critical that regulation came alongside the necessary support to “enable all managers to meet the high quality standards that we expect”.
The deputy chief executive of NHS Providers, Saffron Cordery, said the “vast majority” of NHS managers go to work every day determined to do the best they can for patients but where there was misconduct, it was “absolutely right” they were held accountable for their actions.
However, she also warned it was vital that regulation was “fair and equitable” and “proportionate”.
“Regulation must support a culture of openness that we know is critical to delivering consistently safe care. Crucially, regulation must be independent of both those being regulated, and of politics,” she added. “The focus must be on accountability rather than blame and punishment.”
Labour’s plans to formally regulate NHS managers were first revealed by the Guardian in June.
In an interview at the time, Wes Streeting, then the shadow health secretary, said: “I think the only way in which we genuinely protect whistleblowers and create a culture of honesty and openness is if you have tough enforcement.
“I’m deadly serious when I say NHS managers who silence whistleblowers will be out and will never work in the NHS again. It is the number one priority for the system.”
Rachel Power, the chief executive of the Patients Association, a patient charity, said she welcomed the public consultation on proposals to regulate health service managers.
“Patients tell us that accountability and transparency is often lacking in their healthcare journeys. We encourage everyone who has experienced NHS care, especially those who have felt unheard by the system, to contribute their views.”