New rule to stop NHS directors ‘revolving door’

Officials at the Department of Health and Social Care are working on the proposal, originally made by Tom Kark QC in his report to the department, published in February, on the fit and proper person test regulations.

Speaking at the Patient Safety Learning conference in London today, Mr Kark, said he had been informed earlier this week that government had now accepted his recommendation for mandatory references.

This is in addition to earlier accepted recommendations on drawing up competencies for board level directors and creating a database of board level managers including their past history and experience.

Mr Kark, who was lead counsel at the Mid Staffordshire Foundation Trust public inquiry, said the idea of mandatory references was designed to prevent failed directors benefiting from what he called “vanilla references”.

In his report, Mr Kark said a mandatory reference would be completed when a director moved to a new organisation and would include “full, open and honest information about the director concerned, which could not not lawfully be curtailed by the terms of a settlement or compromise agreement”.

Speaking today, Mr Kark said: “The reason we thought that was important was because you need not rely on the prospective director to tell you about him or herself, covering it with a vanilla reference that says they worked at this hospital from ‘A date’ to ‘B date’ and they weren’t terribly dishonest. That doesn’t actually help anybody.

“You all know about the revolving door of the NHS and compromise agreements and one of the essences of a compromise agreement is very often a standard or agreed reference.

“Mandatory references should knock that out the window so that actually good information should be following each director.

“I was told two days ago that the mandatory reference recommendation has been accepted by the government and there are people in the department working on what that should look like.”

Mr Kark said he believes the recommendation could help change the makeup of hospital boards.

One controversial proposal in the Kark report was for the establishment of a Health Directors’ Standards Council which could investigate and bar directors guilty of serious misconduct. This is still being considered by Baroness Dido Harding, chair of NHS Improvement.

News that the proposal has been adopted by the government led to criticism by NHS Providers chief executive Chris Hopson who told HSJ: “We can see why the government has accepted this recommendation but it concerns us that they are still making important decisions that affect the day to day running of trusts without properly consulting or involving those who actually have to implement these decisions. Talking to NHS England and Improvement is not the same as talking to frontline leaders or their representative organisation.

“More happily, there is a strong and effective consultation process on the other Kark Review recommendations as part of the work on the NHS People Plan. NHS Providers, frontline trust leaders and a broader group of stakeholders, including whistleblowers are contributing to this exercise and we are having a quality discussion on some highly complex issues. That is how to create the right decisions that can be implemented successfully to deliver the desired outcome”.

The DHSC was approached for comment but did not provide a substantive response to questions on whether the mandatory proposals had been accepted.