Is Kark barking up the wrong tree?

On 6 February, the government published Tom Kark QC’s review into the Fit and Proper Persons Test.

Kark had been tasked by the government in July 2018 to review how effective the FPPT is “… in preventing unsuitable staff from being redeployed or re-employed in the NHS, clinical commissioning groups, and independent healthcare and adult social care sectors.”

Kark found that the FPPT has “few fans” in the way that it is currently applied: it does not do what it holds itself out to do and does not ensure that directors are fit and proper for the post they hold. Nor does it stop the unfit or misbehaved from moving around the system.

In the FPPT context, it’s not competence that causes difficulties for NHS employers; it’s dealing with difficult issues around whether a director is of “good character”

Although some of his recommendations are sensible enough, the report is disappointing because Kark doesn’t seem to appreciate the problems NHS organisations face in implementing the FPPT.

In the FPPT context, it’s not competence that causes difficulties for NHS employers; it’s dealing with difficult issues around whether a director is of “good character” and whether they may have been involved in some way in “serious mismanagement” or “serious misconduct”.

The Kark report has seven recommendations, of which the government has accepted the first two:

1. All directors (executive, non-executive and interim) should meet specified standards of competence

2. Creation of a central database to hold information about directors’ qualifications and history

3. Creation of a mandatory reference requirement for each director

4. Extension of the Fit and Proper Persons Requirement to all commissioners and other appropriate arms-length bodies

5. Creation of a body (“Health Directors Standards Council”) with powers to disbar directors for serious misconduct

6. Amending the FPPT to remove the reference to directors ‘being privy to’ mismanagement

7. Further work to be done to ascertain whether the FPPT needs to be amended in the field of social care

It’s not hard to agree that identified core competencies for directors is a good thing, but it’s missing the bigger concern. NHS employers regularly deal with competency issues with directors and, for the most part, they do that reasonably well.

Similarly, it’s difficult to disagree in principle with a central database of director qualifications and history, but I doubt this will significantly improve the application of the test.

Whether the five other recommendations are implemented remains to be seen but it’s tempting to conclude that Kark may be more bark than bite.