A registration scheme to protect vulnerable people will force managers to make moral judgements about people’s lifestyles and place a “significant” financial burden on the NHS, HSJ has been told.

Under the vetting and barring scheme, employers are obliged to give the Independent Safeguarding Authority any information about individuals who may pose a risk to the vulnerable adults and children they work with.

How did we get ourselves into creating an entirely new quango with this level of interference into people’s lives?

From November, employers will be legally required to check whether staff are registered with the ISA.

But managers say it is unclear when they will be expected to refer individuals and how this information will be interpreted by the ISA.

NHS Employers director Sian Thomas said: “There’s huge scope for confusion about what the actual purpose is, how it fits with regulation generally and how it fits with an overall strategy for public protection.”

She said the costs for the NHS would be “significant”, potentially doubling the cost of carrying out Criminal Records Bureau checks - thought to be around £12m a year - and adding to managers’ workloads.

Draft guidance from the ISA says that, in deciding whether an individual should be referred, employers should consider whether there is any presence of “an impulsive, chaotic, unstable lifestyle”.

They should also take account of whether the person has “elective links with antisocial peers and/or associates” or suffers “severe emotional loneliness”.

Council for Healthcare Regulatory Excellence chief executive Harry Cayton said such “moral judgements” could potentially apply to someone going through a family breakdown.

He said: “Regulation should be proportionate and targeted. It should be transparent and fair. The general feeling is that the ISA is none of these things.”

He criticised the ISA’s ability to strike a worker off the register even if their professional regulator had decided they should be allowed to practice.

Mr Cayton said: “Given that we’re talking about having less rather than more regulation, how did we get ourselves into creating an entirely new quango with this level of interference into people’s lives?”

Managers in Partnership chief executive Jon Restell said his members were concerned the lack of clarity would lead to trusts adopting different practices.

A Department of Health spokesman said: “The new vetting and barring scheme is a measure designed to help prevent those who are known to be unsuitable from gaining access to children and vulnerable adults through their work in the NHS.

“It will also contribute to patient safety through sharing of information with regulatory bodies like the General Medical Council and the Care Quality Commission.”