• People plan committee leaning towards voluntary register for directors
  • Recommendations to go to Baroness Dido Harding and ministers

Policymakers look set to reject recommendations to introduce a compulsory register for NHS directors, instead favouring a voluntary register. 

Last year’s Kark review of the fit and proper person test called for a central database of all NHS directors’ qualifications and history. It also called for the creation of a new body, which Tom Kark QC called the “health directors’ standards council”, with the power to investigate complaints of serious misconduct by directors, and bar them from sitting on NHS boards.

However, several well-placed sources told HSJ the working group set up to consider the NHS’ response to the review as part of the NHS’ “people plan” programme, was instead considering a voluntary register as a possible solution. The group is keen to avoid what they see as the bureaucratic demand and complexity of creating a new regulator for managers, according to the sources.

HSJ understands the group is likely to settle on recommending a greater level of regulation than currently exists, but stop short of a statutory register, with one source describing full statutory regulation for managers as like using “a sledgehammer to crack a nut”. There are also discussions about what information should be collected and how to encourage people to join the register.

The working group is chaired by former trust chief executive and former Department of Health workforce director Andrew Foster, and includes representatives from the regulatory world, provider trusts, unions and whistleblowers.

It is finalising its recommendations to be passed on to NHS Improvement chair Baroness Dido Harding, who is leading work on the NHS people plan. A final decision is not expected until it is published, currently due to be March or April. 

The government asked Baroness Harding to draw up and consult on responses to key recommendations made by Mr Kark, who examined the operation of the fit and proper person test regulations. These were implemented after the Mid Staffs poor care scandal but have come in for criticism. 

Baroness Harding has previously backed the idea of professional regulation for senior managers.

Chris Hopson, chief executive of NHS Providers and a member of the working group, told HSJ the “good piece of work” looking at how to implement Mr Kark’s recommendations was “taking time”.

“It’s highly complex balancing a number of different requirements, including the fact that a register of the type Kark recommended requires primary legislation and an organisation with [Nursing and Midwifery Council/General Medical Council] type powers,” Mr Hopson said.

“We all agree on the need to strengthen the way the system currently works — the question is what improvements can be made quickly and effectively, with a voluntary register one of the options being examined.”

Mr Hopson stressed Baroness Harding and ministers had yet to make a final decision.