National competency standards to regulate manager performance

The decision to develop the standards is contained in a Department of Health paper on regulation called Enabling Excellence, published last week.

The paper says the move follows “strong public, patient and professional concern about instances where senior managers who have let people down appear to have avoided significant consequences for their actions”.

It adds: “Whilst the precise nature of this mechanism needs to be discussed further… as a foundation for this, we will commission independently led work to agree consistent standards of competence and behaviour for senior NHS leaders.”

Proposals to regulate NHS managers were developed by a DH advisory group last year following a recommendation in the Francis inquiry into the Mid Staffordshire Foundation Trust scandal.

Former prime minister Gordon Brown also pledged in the run-up to the general election that failing managers would be dealt with in the same way as underperforming doctors, by being “struck off” a register.

Although the most recent plans do not include a statutory register, they are the first demonstration by the new administration of an appetite for the regulation of managers.

They open up the possibility of a voluntary register for managers, accredited by the Council for Healthcare Regulatory Excellence, which is due to be renamed the Professional Standards Authority for Health and Social Care.

CHRE chief executive Harry Cayton said: “We’re looking at whether the voluntary register mechanism would be sufficient to meet the needs of greater clarity of standards for management. My view is it probably would.”

He said it was likely the national standards would focus on personal and professional ethics, behaviour towards colleagues and technical abilities such as analysing financial data accurately.

This would allow colleagues to “challenge” those who were behaving inappropriately because “everyone would know what inappropriate behaviour was”.

He suggested the standards could be based on the General Medical Council’s good medical practice guidelines.

These state doctors must “be honest and open and act with integrity” and “not make unjustifiable claims about the quality or outcomes” of services.

The Institute of Healthcare Management publishes a code of conduct, which it is updating. A draft says managers should show “politeness in any interaction” and be aware of the “use of body movements and expressions to show attentiveness”.

Occupation health psychologist Derek Mowbray, who wrote the draft, said it was aimed at reducing the “psychological distress” caused by bullying and bad management cultures.