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Former nursing director referred to CQC under new ‘fit and proper’ regulations


A former nursing director is among the first senior NHS managers to be referred to the Care Quality Commission under new “fit and proper person” regulations, Nursing Times has learned.

The individual is among more than 20 reported to the regulator under the new legislation aimed at improving corporate accountability and ensuring managers are fit to lead.

A group of whistleblowers and campaigners has made seven formal submissions alleging several managers are unfit for board level positions because of their past actions or behaviour, it has emerged.

“The CQC will no doubt want to be reasonably confident the individual is not a fit and proper person before it takes any action”

Hempsons law firm

Information obtained by Nursing Times’ sister magazine HSJ shows those named include at least one senior figure from the world of nursing – a former director of nursing at an acute trust - alongside current and former trust chief executives and medical directors.

Under the regulations, directors, including directors of nursing, can be deemed “unfit” to sit on boards if they have been involved in “serious misconduct or mismanagement”.

The CQC can, via the provider registration process, require the removal of directors found to be unfit.

The referrals are understood to be the first to be made since the legislation came into effect in November last year.

Nursing Times and HSJ has chosen not to name the people referred at this stage.

The fit and proper person test was a key recommendation of the Francis inquiry into care failings at Mid Staffordshire Foundation Trust.

When the concept was consulted on, the Royal College of Nursing said it backed the idea but stressed the test must be applied fairly.

There were concerns it could have a disproportionate impact on directors of nursing because of the extent and nature of their responsibilities.

The RCN also warned those directors with a professional role – such as directors of nursing and medical directors – would in effect be subject to “dual regulation”.

It highlighted the need for the test to link up to and complement the work of professional regulators like the Nursing and Midwifery Council.

Paul Spencer, employment partner at the law firm Hempsons, said he expected the CQC to forward the concerns to individual trusts and only make a decision once a response had been received.

“It is for the relevant trust and the chair to be assured the relevant director is a fit and proper person,” he told HSJ. “The CQC will no doubt want to be reasonably confident the individual is not a fit and proper person before it takes any action. This is the start of a potentially very long process.”

Meanwhile Jon Restell, chief executive of Managers in Partnership, which represents health service managers, admitted there was widespread confusion about the new law.

“It can only add to the risk and uncertainty building up for these roles if any issue can be referred and… investigated”

Managers in Partnership

“It can only add to the risk and uncertainty building up for these roles if any issue can be referred and any issue investigated,” he said.

“We are not saying these cases do not need to be investigated but if people are using this law to further personal agendas I think the CQC needs to signal early on what they will and will not entertain.”

A CQC spokesman said it had received seven formal submissions under the fit and proper person regulations.


Readers' comments (9)

  • Since the Mid Staffs scandal thousands of practising nurses, midwives and health visitors have been reported to the NMC (0.6% of UK 600,000+ registrants).

    Yet this body has taken no meaningful action against senior nurses who agreed to staffing cuts and deskilling their workforces, whilst collecting bonuses and all the other goodies associated with board membership. I hope the CQC takes account of that.

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  • We can put the blame of the decline of nursing on many things, but I always believe that senior nurses cause the major decline.
    Only today a pretty young HCA was saying how the matron told her that as soon as she gets her nursing qualifications to come have a meeting with him and he will 'look' after her.
    In the hospital I work, one can take a survey on how many young inexperienced sisters run the wards as they got the position not because of qualifications or experience but because of someone they know.
    Most Nurse Managers are lacking in ability to do the job and the good nurses hardly move from the shop floor.

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  • The above two comments are very knowing. The problem lies within the field of nursing.
    Nurses make shocking managers but......the nursing profession can't believe that a non-nurse i.e. a beancounter can manage them better than their used-to-be best friend nurse.
    Wake up.

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  • 22/1/2015
    Both the above comments have some validity.
    Yes it is startling how inexperienced some nurses are when promoted to posts such as Deputy Ward Manager. What level of experience and expertise can anyone gain after being trained for only 12 months?
    However I draw the line when the "Bean counters" throw their weight around in the management and even application of Clinical matters of which they can be remarkably ignorent.
    Unfortunately the NHS has become "banding" obsessed and drawing nurses into Agenda For Change has given the profession nowhere to go independently. As a result the chance to make Nursing an attractive profession to enter has been seriously damaged for the present and in the future.

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  • The comments attributed to Peter Carter in the above item are extremely disingenuous in claiming that nursing or medically qualified managers can be subject to "dual regulation": how many times have either the GMC or NMC (or the UKCC) taken action against a manager who just happens to still hold the relevant registration? A vanishingly small number...

    It is about time there was some form of regulation of managers to hold them to account in the same way as all the clinical disciplines.

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  • To support previous commenters, it is my experience (30 years in nursing) that nurses do not make good managers.

    There are several reasons for this: one is the appalling state of NHS management training, which is full of jargon, buzz words, the latest fads and totally lacking in a coherent evidence base. However, no-one seems to challenge the orthodoxy because to do so would stop you getting on the management gravy train. I have yet to meet a manager, from any background, who could tolerate you questioning the basis on which they make any decision, or in fact tolerate being questioned at all.

    Nurses who enter management also appear to "go native" faster than any other clinical discipline and adopt the mantles and mantras of "managerialism" far faster and more completely than others, appearing to forget where they came from and what they should be there for.

    And that is before we examine the idea of personality disorders and their prevalence in management...

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  • I have had a first hand problem with a senior manager when voicing my concerns over the demoralized staff of a rehabilitation ward. I was told it was people like me who caused it and if they had interviewed me when I applied for my job they would not have employed me. How I wish I had a recording of the interview. The terrible thing is they have even gone on to bigger things

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  • michael stone

    BasketPress, re your:

    'I have yet to meet a manager, from any background, who could tolerate you questioning the basis on which they make any decision, or in fact tolerate being questioned at all.'

    It seems to be very common, and not confined to nursing, for people to not be exactly 'receptive' towards their decisions being questioned.

    The 'paradoxical' aspect of that, is we [public] are forever being told that 'the NHS is going to be more open, and to learn from critical feedback' (my phrase to describe this particular theme) - you can't 'learn from critical feedback', if you think your decisions were all perfect.

    If 'the NHS' were good at listening to critical feedback, there wouldn't be the furore over 'whistleblowing', would there ?

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  • In my previous directorate it was common for D grades to be promoted to F/G posts, bypassing experienced E grades. An obvious case of 'if your face fits'. The management wanted someone who was compliant and easily moulded to fit the Directorate structure. They made lousy managers because they had no senior experience. At the time I was an F grade sister appointed way before we became a Trust and our manager (GP husband who had trained with our consultant) was a nasty piece of work who actually threatened a G grade and me with 'making our lives hell' when we pointed out that the nurse who had scored least points during the interview was given the post. I was asked if I thought that I was 'right' for my job and perhaps should consider applying elsewhere if I wasn't happy. So I did!

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