CQC to oversee barring scheme for directors

In its response to the Francis report published earlier today the government revealed it would press ahead with plans to introduce a barring scheme for health service managers.

In future all executive and non-executive directors will be subject to a fit and proper person test which, as well as checks for criminal convictions and bankruptcy charges, will consider whether the individual has the “qualifications, skills and experience necessary”.

If the CQC finds a director is unfit following an inspection or on being notified of a new appointment, it can demand the organisation removes the individual. If the organisation refuses it could face prosecution.

Health minister Norman Lamb said the health and social care regulator would be given additional powers through an amendment to the Care Bill currently going through Parliament. He said this would include a right for individuals to “challenge” the CQC’s decision.

“There is a need to ensure there is proper natural justice,” he said.

The response said the barring scheme will be kept under review and the government would legislate for the regulation of managers if it is “not having its desired impact”.

The decision to rollout the scheme goes against the advice of the government’s advisory group that it would not be “proportionate” and managing the tension between fairness for individuals and cost effectiveness for the taxpayer would be difficult.

It suggested most of the objectives of a barring scheme could be achieved through better application of existing employment processes. In its response the government said it was important for organisations employing senior leaders “to use the means already available to them”.

As the barring scheme will only apply to organisations regulated by the CQC, clinical commissioning group governing bodies and NHS England will not be covered.

The government’s response said NHS England would “explore the development of a parallel set of arrangements for clinical commissioning groups”.

A fit and proper persons test and the ability to remove individuals found not to meet it was a key recommendation of the Francis report and the government indicated it was minded to introduce a barring scheme in its initial response back in March.

Corinne Slingo, partner in healthcare regulatory and public law DAC at Beachcroft, said the issue was generating a lot of concern on boards.

She added: “The question is how do you know when it’s an individual manager or director who is responsible for a particular course of events or the system?”

NHS Confederation director of policy Jonny Marshall said it was important to recognise the challenges leaders faced particularly in the “most troubled organisations”.

He added: “The detail of how it is to work in practice will be absolutely critical. We must avoid any increase in the ‘blame game’ which Robert Francis warned against.”