‘Performance variation’ may justify manager regulation, says Barclay

Last week, HSJ reported how NHS England chief executive Amanda Pritchard had called an urgent meeting to discuss the prospect of introducing a formal regulator for managers, with powers to prevent people moving to new jobs when serious misconduct has been found.

She said this was in response to fallout from the Lucy Letby murder trial, and how executives at the Countess of Chester Hospital had dealt with the case.

But the health and social care secretary told parliament this afternoon: “In light of the evidence from Chester, and ongoing variation in performance across trusts, I have asked NHSE to work with my department to revisit [the potential for new powers to disbar senior managers].

“They will do so alongside actions recommended by Sir Gordon Messenger’s [2022] review of NHS leadership… this will ensure the right standards support and training are in place for the public to have confidence that NHS boards have the skills and competence needed.”

He said NHSE had previously considered powers to disbar senior managers, following the review of the fit and proper person test by barrister Tom Kark in 2018, but decided it wasn’t needed at that point.

Mr Barclay also announced that court of appeal judge, Dame Kate Thirlwall, will chair the public inquiry into events at CoCH, with full statutory powers to compel witnesses to give evidence.

He said the inquiry would happen in phases, to get answers more quickly, and the families of Letby’s victims will have input into the terms of reference.

He added: “We have a duty to get them the answers they deserve, to hold people to account and make sure lessons are learned.”

NHSE has also been asked to review guidance that allows trust board members to have the freedom to speak up as guardians, to ensure the roles are independent.

There has been intense criticism over the last fortnight of how the former CoCH leaders responded to concerns raised about Letby. This has included questions about how the trust’s former chief executive, Tony Chambers, was appointed to several executive roles since leaving the trust.

Mr Chambers has defended his actions while in charge at the Countess of Chester, and said the coming public inquiry will be the best forum to scrutinise what happened.