Sacking directors of nursing and other senior figures following damning reports from regulators should not be seen as the solution to improving patient care at failing trusts, the chief inspector of hospitals at the Care Quality Commission has said.
Sir Mike Richards said that, following high profile reports in recent years, it must now be recognised that wider systemic problems often contribute to care failings and that removing senior leaders does not guarantee improved patient safety.
“It’s no good just sacking people and expecting a new supply of directors of nursing… to come along”
Sir Mike Richards
He referred to Sir Robert Francis’s inquiry into Mid Staffordshire Foundation Trust and Sir Bruce Keogh’s review of 14 trusts with high mortality rates, which eventually saw 12 placed into special measures.
“At that point it became perfectly apparent that it’s no good just sacking people and expecting a new supply of directors of nursing, chief executives, medical directors to come along,” said Sir Mike, speaking yesterday at the Nursing Times’ Deputies’ Congress in London.
“Actually, we need to put in a support regime as well,” he said, although acknowledging that CQC’s programme for assisting failing trusts had not been carried out “universally well” and that there was room for improvement.
“People don’t want [director of nursing jobs] because there is a fear that when it goes pear-shaped you’re the person that’s in the frame”
His comments echoed those made by Royal College of Nursing chief executive Peter Carter, who was also speaking at the London event.
Referring to a case a few months ago in which a director of nursing lost their job following a critical CQC report, Dr Carter said: “I don’t think it was particularly helpful that an individual was sacrificed, because whoever gets that job is going to find it a really tough trust with huge underlying financial problems.
“And if you haven’t got the money right, no matter how well your intention, you are going to struggle.”
He suggested director of nursing posts were becoming increasingly difficult to fill due to potential candidates fearing they could be targeted and potentially removed if problems occur.
“I am worried about nursing leadership and the number of vacancies for director of nursing posts. People don’t want them because there is a fear that when it goes pear-shaped you’re the person that’s in the frame,” said Dr Carter.