• NHS will consider professional registration of senior NHS managers
  • ICS will be subject to new “comply and explain” accountability regime
  • CQC will put a greater emphasis on system working as part of its regulation of the NHS

Formal regulation of senior NHS managers could be introduced to improve their standing and help fill the most difficult jobs, according to the NHS long-term plan.

The delayed plan, published today, says the NHS will consider “the potential benefits and operation” of a professional registration scheme for “senior NHS leaders”.

The 136-page document said such a scheme would be similar to registration schemes used in other sectors of the economy and for NHS professionals such as nurses and doctors. It said such a scheme could boost the recognition of “the role of NHS management and help the NHS attract and retain the best people for the most challenging jobs”.

While the plan made no mention of managers being struck off for failing to meet professional standards, it did refer to the as yet unpublished review by Tom Kark QC, who was specifically asked by ministers to examine this sanction as part of his review of the Fit and Proper Persons test. 

The long-term plan added NHS leaders and integrated care systems will be subjected to a “comply or explain” accountability regime to drive best practice adoption and involvement in national improvement programmes.

Under a new “culture of support and collaboration” by NHS England and NHS Improvement, the document said there will be “a reinforcement of accountability at board, governing body and local system ICS level for adopting standards of best practice and making their contribution to critical national improvement programmes, on a comply or explain basis”.

While stressing the need for accountability, the long-term plan also promised a new “compact with our most senior leaders” and a NHS leadership code. It pledged more support for those in challenging roles and “appropriate ‘air cover’ when taking difficult decisions”.

It said NHS England and NHS Improvement “will consistently model the behaviours we expect to see from leaders in our interactions with them. These commitments will be enshrined in a new ‘NHS leadership code’ which will set out the cultural values and leadership behaviours of the NHS and will be used to underpin everything from our recruitment practices to development programmes.”

In addition, the Care Quality Commission will place “a greater emphasis…on partnership working and system-wide quality in its regulatory activity, so that providers are held to account for what they are doing to improve quality across their local area”.

In order to deliver the ambitions in the plan and reduce unwarranted variation, the NHS needs “systematic methods” of quality improvement to be adopted by all areas. According to the document, the NHS will work with the Health Foundation to increase the “improvement capability” of ICS.