Ministers are considering creating a “blacklist” of NHS managers who preside over failure and would be prevented from working in the health service again, HSJ understands.
A “negative register” would list the names of individuals who have been judged unfit to practise based on their previous performance.
HSJ understands the idea is one of a number being considered by ministers ahead of the publication of Robert Francis QC’s report into failure at Mid Staffordshire Foundation Trust. Mr Francis is widely expected to recommend strengthening the regulation of managers in the NHS.
The negative register was discussed at a private meeting earlier this month, hosted by the NHS Confederation and attended by health secretary Jeremy Hunt.
Mr Hunt is reported to be considering the idea but is waiting the publication of the Francis report before deciding upon on a preferred approach.
King’s Fund head of policy Anna Dixon, who was not at the meeting, told HSJ the negative register, or “blacklist”, could be an “attractive option” for ministers.
She said: “There isn’t a desire from anyone in government to introduce a large scale regulatory process for every manager; this idea has come up as a potentially low cost, low regulatory burden approach.”
However, she warned it could deter candidates for difficult chief executive roles if individual culpability was seen to take precedence over corporate governance.
The Department of Health has already asked the Health and Care Professions Council to draw up costings for a negative register for care assistants working in social care settings.
The council, which regulates professions including radiographers and occupational therapists, put forward the idea after concluding voluntary regulation would not work for this group.
In a recently published position statement the council argued there were “significant shortcomings” with a voluntary approach, notably that individuals judged unfit for one role could not be stopped from getting another job elsewhere.
The council suggested the negative register approach would be “scalable” to other health and social care settings and proposed it be funded through the Care Quality Commission licensing fee, paid by providers.
Voluntary regulation is currently the government’s favoured approach to regulation of healthcare assistants, another area in which Mr Francis is expected to make recommendations.
HSJ has learned the possibility of a negative register for healthcare assistants has also been discussed by DH officials.
The government introduced a similar scheme for teachers last year following the abolition of the General Teaching Council.
Mr Hunt has previously shown interest in adopting ideas from the education sector, commissioning the Nuffield Trust to explore the potential of introducing an Ofsted-style ratings system for hospitals and care homes.