Details of new 'fit and proper person' test for NHS leaders unveiled
A register of poor performing directors of nursing and other healthcare leaders is to be set up by the Care Quality Commission to prevent unfit managers working and moving between organisations.
Under plans to bring in a new fit and proper person test, the CQC will record concerns about individual directors. This includes where directors deemed to be unfit resign before the regulator has imposed any conditions on their trust.
Those individuals deemed unfit under the new check would then be removed from their posts or barred from joining a new organisation, preventing failed senior managers from moving between different providers, the government said.
“This test will allow us to make sure that those leading healthcare organisations are up to the job”
The details have emerged in draft regulations for the new test published by the Department of Health yesterday.
It will cover persons at board level or equivalent in all organisations registered with the CQC, whether in the private, public or voluntary sectors.
The test will be used when an organisation registers with the CQC for the first time and when a new director is appointed to an organisation that it already inspects.
Creating a fit and proper person test for healthcare leaders was a key recommendation of the Francis report following the public inquiry into failures at the Mid Staffordshire Foundation Trust.
Ministers hope the new test could be put into place as early as October. The government expects around seven directors would be found to be unfit each year.
The regulations describe that to qualify as a fit and proper person a director of an organisation must:
- Be of good character;
- Have the qualifications, skills and experience necessary for the role;
- Be capable of undertaking the position;
- Not have been responsible for misconduct or mismanagement in the course of any employer with a CQC registered provider;
- Not be prohibited from holding the position under existing laws.
A director could be deemed to be unfit if:
- They have been convicted of a criminal offence or sentenced to three months in prison within the last five years;
- They are an undischarged bankrupt;
- They are subject of a bankruptcy order,
- They have undischarged arrangements with creditors;
- They are included on any barring list preventing them working with children and vulnerable adults.
The DH claims the test will close a “regulatory gap” with directors being the only group not subject to existing fit and proper tests. It will apply to board directors and their equivalents including executive directors, non-executive directors, chairs and trustees. It will not apply to hospital foundation trust governors.
NHS England will also explore developing a parallel set of rules which will apply to clinical commissioning groups.
Care minister Norman Lamb said: “Scandals like Winterbourne View and Mid Staffs damaged confidence in our health and care system.
“This test will allow us to make sure that those leading health and care organisations are up to the job – and to remove those who are not, including those who have presided over poor care.”
A consultation on the draft regulations runs until 25 April.
An example of how the new regulations would work:
Mr B has applied to be a chief executive at a NHS trust X. However, in his last trust, Y, where he was director of midwifery and nursing, a CQC inspection found the maternity unit is unsafe. Mr B is removed as a Director by the Trust as a result of CQC’s action. NHS trust X are unaware of this, and they appoint him to be their new chief executive.
However, under the new rules being consulted upon, when trust X notified the CQC that they were planning to appoint Mr B as chief executive (which they already have to do), the CQC checked his name against their records. They found his record of overseeing poor patient care, and informed Trust Y who did not continue with their recruitment of Mr B.