Clinical directors could be regulated under government proposals

Clinical directors and PCN managers could be regulated under new plans released by the Government.

The proposals, launched by the Department of Health and Social Care (DHSC) last month, set out measures that aim to increase accountability of NHS managers and leaders, and set ‘clear and consistent’ professional standards.

A 12-week consultation has been launched on the proposals, which could mean that, in future, NHS managers found guilty of serious misconduct that endangers patients could be banned from working for the health service.

The plans include options for regulation, ranging from:

• creating a list of ‘barred’ individuals deemed unfit to practise in the profession as a result of poor conduct
• developing a professional register of individuals held by a regulatory body (like the GMC). This could be voluntary or made compulsory to join (via full statutory regulation).

Statutory regulation would require individuals to meet a set of professional standards/an approved qualification before entry on the register, which ‘would put managers on a similar regulatory footing as medical and nursing colleagues,’ the DHSC consultation document said. It could also result in managers having to undertake revalidation and paying annual registration fees.

As ‘a minimum’, any new regulatory system will apply to all board level directors in NHS organisations in England, arm’s length body board level directors and ICB board members, the plans have said.

However, its scope is likely to be much wider as the consultation seeks views on which managers and organisations any future duty should apply to. This could include PCN managers and PCN clinical directors, DHSC confirmed to our sister title Management in Practice.

Where a manager is also a clinician and therefore already held to account by another regulator, such as the GMC, a system of ‘dual registration’ is being proposed, so they would be regulated in both their roles.

The Government is also consulting on whether to introduce a new professional duty of candour on managers, which would make them legally accountable for responding to concerns about patient safety.

This was one of the recommendations made in the Infected Blood Inquiry’s final report published in May to encourage transparency and open behaviour.

Meanwhile, NHS England is developing a set of professional standards for NHS managers, since none exist currently.

They will bring in a code of practice, a set of core standards and competencies for managers and leaders at all levels in the NHS, as well as a national training curriculum.

‘This will support managers and leaders to undertake further training to improve their effectiveness and to progress in their careers,’ the consultation said.

Amanda Pritchard, chief executive of NHS England, said: ‘It is right that NHS managers have the same level of accountability as other NHS professionals, but it is critical that it comes alongside the necessary support and development to enable all managers to meet the high quality standards that we expect.

‘We welcome this consultation and already have a range of work underway to boost support for managers in the NHS and to help set them up to succeed – this includes creating a single code of practice, a new induction process and a new set of professional standards, which will ultimately help drive improvements in productivity and patient care.’

Deputy chief executive of NHS Providers, Saffron Cordery said is was ‘absolutely right’ that managers are held accountable for their actions.

‘With patient safety at the heart of what trust leaders do, they will broadly welcome this consultation,’ she said.

‘While we wait to see the detail of the consultation, it’s clear that any of the proposals on the table must pass a series of litmus tests if they are to have the confidence of patients, staff, and the managers they seek to regulate.

‘Alongside the critical focus on quality of care and patient safety, it is vital regulation is fair and equitable, proportionate and offers support and development for managers.’

She also called for a culture of openness and a focus on accountability ‘rather than blame and punishment’.

The consultation closes on 18 February 2025.

A version of this story was first published on our sister title Management in Practice.