Details of NHS fit and proper person test emerge

HSJ understands the test will be place a “clear duty on service providers” to make sure directors appointed to their board meet criteria set out in the test.

The Department of Health has published a consultation document on the plans which reveals the test will apply to all directors appointed to NHS trusts and foundation trusts, independent healthcare and social care organisations.

Guidance will set out the details of the test but the DH today said it would be aimed at identifying concerns about an individual’s background and would use criminal checks as well as general or financial background searches.

These would include examination of an individual’s honesty and integrity, competence and capability and previous history as a director.

Anyone who fails the test could be removed from the post and the CQC would be able to insist that this happened.

The fit and proper person test was part of the government’s response to the Francis report into the Mid Staffordshire Foundation Trust public inquiry which highlighted a lack of accountability at senior levels in NHS bodies.

The details were revealed today as health minister Norman Lamb revealed plans to make it easier for managers in charge of hospitals and care homes to be charged with criminal offences following care failures at their organisations.

Mr Lamb will unveil new plans to address a loophole in the system which means providers responsible for failures in care can escape prosecution.

He said the proposals will make it easier for the CQC to prosecute providers and their directors where there are clear failures to meet very basic standards of care.

Since the CQC took charge of regulation of health and social care in 2009, there have been no such prosecutions, a Department of Health spokeswoman said.

She said that providers responsible for poor care can escape prosecution, even in the worst cases, because the CQC can only prosecute when it has previously issued a warning notice to the provider and it has failed to comply with that warning notice.

Officials want to remove the layer of protection for health and care providers and enable the CQC to be able to prosecute without giving notice.

Mr Lamb said: “Scandals like Winterbourne View and Mid Staffs have damaged confidence in our health and care system.

“Part of our commitment to rebuilding that trust comes from making sure that people at all levels are held to account for failings when they occur.

“Whilst there must be a sharper focus on corporate accountability, more needs to be done to ensure those responsible for leading a care organisation are up to the job. I hope that providers and people who use services and their families will respond to this consultation as we look to take these proposals forward.”

The proposals are part of a wider remit of changes to the way the CQC regulates health and social care providers.

Mr Lamb said the new plans would seek to impose fines rather than jail terms following prosecutions.

He told ITV’s Daybreak: “We’re not jailing but it would be unlimited fines and it will be for the awful cases.

“If you break the fundamental standards that you have to comply with as a provider of care, and you are responsible for that, there are consequences, and I think that’s what the public expect.”

He added: “There’s also a culture when awful things happen, there’s a cover up, people get paid off, they get gagged from talking about it. That has to end.

“These pay offs have to end and people at the top of the organisation should be held to account.”