Settlements between NHS trusts and whistleblowers should be scrutinised by the Care Quality Commission to ensure organisations are well led, the Francis review has recommended.

As part of measures to increase transparency in the way trusts handle whistleblowing concerns, the review led by Sir Robert Francis QC says chief executives should “personally” review settlement agreements that contain confidentiality clauses to satisfy themselves the clauses are “in the public interest.”

The report, published today, also said: “All such settlement agreements should be available for inspection by the CQC as part of their assessment of whether an organisation is well led.”

Sir Robert added the all NHS organisations should be required to report formal concerns, public interest disclosures and outcomes of disputed investigations to the National Learning and Reporting System, the new national independent whistleblowing officer and relevant regulators.

The review added: “The NLRS or the independent national officer should publish regular reports on the performance of organisations with regard to the raising of and acting on public interest concerns; draw out themes that emerge from the reports; and identify good practice.”

In the report Sir Robert questioned what he described as “the excessive use of confidentiality clauses”, adding: “I question, for example, whether it is in the public interest for an employer to sign a confidentiality agreement relating to a performance issue involving a senior employee if that enables them to move to another public sector post, possibly on promotion.

“I suggest that NHS organisations, and the lawyers who advise them, should take great care to ensure any confidentiality clauses are drafted in a way that is easily understood by both parties and are genuinely in the public interest. A good starting point would be that any confidentiality clauses need to be justified rather than including them automatically.”