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'At last chiefs are held responsible for actions'


A group of whistleblowers and patient safety campaigners have raised concerns about 20 NHS trust leaders under the fit and proper person’s test, which was introduced last October.

Jenni Middleton

Nursing Times has not named them – nor has our sister title Health Service Journal – they are innocent until proven guilty.

We are, however, delighted that this test is in place and is being used and publicised.

A test for board-level directors was recommended almost two years ago in the Francis report into Mid Staffordshire Foundation Trust. It is an important step in recognising that clinicians are not the only ones who affect care standards. Nurses are often chastised for care failings – by patients, relatives and the media – for problems caused by factors over which they have little control, such as staffing levels.

Those in charge should take some responsibility; they may have cut resources or failed to listen to staff concerns, causing a poor patient experience or compromising patient safety.

Before the test was introduced, nurses could be struck off for failing to adhere to the Nursing and Midwifery Council code, but their chief executives could walk away from situations even if their decisions had put patients in danger. Some of the most notorious moved to other senior jobs in the NHS with ease.

It’s time the system recognised that patient safety and dignity aren’t purely the responsibility of nurses or other clinicians

It’s time the system recognised that patient safety and dignity aren’t purely the responsibility of nurses or other clinicians. Decisions taken in the boardroom can have as much of an effect as those taken at the nurses’ station. Making directors accountable for those decisions is vital – patient safety is also their business.

Under the regulations, the Care Quality Commission investigates claims that board-level directors are not acting with competence, capability, honesty and integrity, and can dismiss people from such jobs and prevent their appointment to other senior posts.

The vast majority of board members have nothing to fear. The handful whose decisions jeopardise patient safety can now expect to face the consequences, just as clinicians do. The playing field, it feels, has been levelled somewhat.

Jenni Middleton, editor
Follow me on Twitter @nursingtimesed


Readers' comments (5)

  • At last. There have been too many occasions when nurses have been blamed for poor care when the problem has been that the budget has been cut, too few staff on duty and those on duty are doing their best. The budget holder gets a pat on the back for cost improvements. Lets see if this changes now and lets see if anyone in a grey suit is held accountable for poor or inappropriate staffing levels.

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  • yeah right, it is in fact the nurses that will always get the blame, managers will always get off scot free, managers are important, nurses are seen as something that can be trashed

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  • The boardroom is actually responsible for virtually every care failing the NHS has ever seen. However they are rarely if every truly held accountable for their actions. About time that managers and MPs careers are finished by poor decisions like nurses and some doctors.

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  • I'll wait until the first one is actually banged-up.

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  • At last. Thank you so much for making this decision. Whistleblowers are not telling tales, they are raising genuine concerns that are noted when working and therefore should be listened to and the problem resolved. By following this procedure a leaking dam can have its holes fixed and not plugged with tissue paper. At last the innocent worker can feel safe and we can take the NHS forward. I feel that the whole NHS needs a radical shakeup and dragged into the 21st Century. Stop blaming eachother. Stop arguing with the Government - They pay your wages so work with them to find out what the problems are. If they don't understand then teach them so they do understand why you are having problems. If they don't listen ask yourself why they are not listening!! Is it because they genuinely just don't understand what is going on? Or is it because they are just under a lot of pressure from a lot of people and don't have time to address what is going on at that moment in time? I find that you cannot build Rome in a day, but you can change the world one day at a time.
    This is a massive step forward and I feel that by remaining passionate and dedicated to what I feel is a brilliant institution gone wrong because people forgot to care and instead became greedy and nasty and moneygrabbing we all forgot why we were there to work. I go to work to help my patients get better. I go to work to make my staff feel wanted. I go to work so my patients will go home at the end of the day and feel like they had a safe and secure time whilst in hospital under my care. I go to work because I care.
    If that makes me unique in todays world then frankly that makes the UK NHS a sad place to be in.
    I go to work because I am a NURSE WHO CARES!!

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