Chief inspector: Fit and proper regulation having 'deterrent effect'

The Care Quality Commission claimed there was evidence of people resigning or being suspended from director posts because of fears they might be unfit for their roles.

CQC chief executive David Behan said at least one trust chief executive had been suspended in relation to the regulation.

The fit and proper person requirement came into force for NHS trusts in November last year, and in April 2015 for all other providers regulated by the CQC.

Under the rule, providers have a duty to make sure all their directors are “fit and proper”. The CQC is not responsible for judging whether individuals meet the definition, but it can take regulatory action against providers it decides are breaching the regulation.

While there have been no recorded breaches so far, Sir Mike said there was evidence the rule was having a successful “deterrent effect”.

Speaking at the CQC’s board meeting yesterday, Sir Mike said: “It may deter people from applying for jobs… It certainly may deter trusts from employing people who would not be fit and proper.

“There may also be occasions where people have left posts that are director posts in order to be in posts that are not subject to the regulation.”

Mr Behan said two trust chairs had commissioned independent investigations into allegations directors were unfit, and one chief executive had been suspended because of the regulation.

“My personal view, I can’t prove it… is that that would not have happened 12 months ago without that regulation,” he said.

However, Sir Mike conceded it was “very, very difficult” to assess the regulation’s deterrent effect.

He added: “I can say to you I think it has had an impact, but so can the head of MI5 or MI6 say they think they’ve stopped terrorist attacks – how would we actually know?”

The CQC has so far been contacted by 27 people with allegations that 68 directors are potentially unfit.

Sir Mike said the “large majority” of allegations related to events that occurred more than two years ago. Twenty-four cases were immediately dismissed by the CQC because they applied to people who were not currently working as directors the English NHS, and therefore fell outside the regulation.

In six cases the CQC contacted trusts about the concerns raised about directors, but most of these cases are now closed.

Sir Mike said where directors had been accused of engaging in bullying and harassment in the past, the CQC had struggled to find evidence linking the bullying to the person in question.

“Where there is that evidence… it’s clear cut [that they are unfit] but very often there hasn’t been that evidence,” he said.