• Ministers announce review of CQC fit and proper person test
  • Review could result in the regulator gaining the power to rule on individuals
  • It will look at the movement of senior managers within the NHS and to private providers

Senior managers in the NHS could face tougher sanctions following a government review of the fit and proper person test.

Ministers are due to announce a review of the Care Quality Commission regulations today in the wake of revelations around care failings at Liverpool Community Health Trust. 

HSJ understands the review could look at the ability of the CQC to make a determination of an individual director’s fitness on the board, which the watchdog has always insisted it is not empowered to do.

Helath minister  Stephen Barclay is expected to tell MPs in the House of Commons today that he will commission a review “within the coming days”. It is not yet clear who will lead the review.

The review’s remit will not be restricted but Mr Barclay is expected to say it will look at four key areas around the regulations, which were brought in after the Mid Staffordshire care scandal in November 2014.

The four key areas include:

  • What happens when an individual manager moves between NHS organisations.
  • What happens when senior leaders move to organisations such as private companies or charities which provide services to the NHS.
  • Where there is a failure to cooperate with a review.
  • How the regulation works where differing levels of professional regulation apply, such as when a chief executive is also a clinician. 

The announcement follows the publication of an independent review into the Liverpoool community trust, by Bill Kirkup, which found the provider sought to “conceal” serious care failings including patient harm.

It also identified a widespread culture of bullying and harassment.

The CQC recently updated guidance on its fit and proper person test to confirm that directors could be dismissed if they fail to act on bullying concerns.

However, the regulator has been clear that it does not have the power to remove an unfit director and instead its role is to assure itself that a trust has complied with the fit and proper regulations.

The regulations have been repeatedly criticised for the CQC’s inability to take action against trusts where managers have been accused of unfit behaviour. This included the appointment of former NHS chief executive Paula Vasco-knight, who was dismissed from her South Devon Foundation Trust role for victimising whistleblowers before joining St George’s University Hospital FT and being cleared by the CQC. She later stepped down and was convicted of fraud.

Last year, HSJ revealed the CQC took enforcement action under the fit and proper person regulations against only one NHS trust, despite numerous complaints against board level managers.