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Francis response: Failing managers could be barred

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Senior NHS managers and non-executive directors who “let their patients and the NHS down” could be barred from holding high-level positions in future, under proposals set out in the government’s response to the Francis report.

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Robert Francis QC recommended a system where executives and non-executives could be disqualified from holding similar positions in future on the grounds of incompetence or serious misconduct, according to LGC’s sister title Health Service Journal.

The government’s response to the report highlights the Teaching Agency’s barring scheme as an example of the type of “mechanism” the government would like to introduce for executives and non-executives.

The agency investigates cases of serious misconduct and organises and administers professional conduct panels as well as holding a register of barred teachers.

The response says: “To deal with the small numbers of managers who let their patients and the NHS down through gross misconduct, and prevent them from moving to new jobs in the NHS, we will introduce a barring list for unfit managers, based on the barring scheme for unfit teachers.”

Health secretary Jeremy Hunt said any system would have to “dine carefully” and with “due process”.

“What we are really trying to do is reassure the public that we will stop the practice whereby someone fails badly in their duty of care to people is able to pop up somewhere else,” he added.

Mr Francis recommended the system be underpinned by a fit and proper person test which as well as standard requirements around bankruptcy and criminal convictions, included compliance with a code of conduct. Mr Hunt said the notion of a fit and proper person test was being explored by Monitor, the NHS Trust Development Authority and the Care Quality Commission but no decision had been made.

The Department of Health plans to discuss with NHS managers whether an assured voluntary register would give weight to the Professional Standards Authority code of conduct for managers. 

The response also reveals plans to attract more individuals from clinical backgrounds and outside of the NHS into management positions.

Initiatives include investment in shortened MBA-style programmes to “ensure clinicians with a talent for leadership are supported in becoming the clinical chief executives of tomorrow”. Similar fast-track programmes will also be available for individuals form outside the NHS to enable them to understand the complexities of the NHS quickly and experience a number of different healthcare settings.

Announcing the plans, health secretary Jeremy Hunt said the fact that former Mid Staffordshire Foundation Trust chief executive Martin Yeates was one of only two candidates for his job showed there was a need to increase the talent pool at the top.

He added: “Clinicians often make the best managers. We need to make it easy and attractive for them to move into NHS management.”

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