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NHS leaders face competency standards as Hancock emphasises importance of ‘open and honest’ culture


By Hiba Mahamadi
6 February 2019

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Health secretary Matt Hancock has issued a strong warning to healthcare leaders not to take patients’ trust in them for granted and create a more ‘open’, ‘honest’ and ‘just’ culture across the NHS.

Mr Hancock has also in no uncertain terms backed whistleblowers as an integral part of the NHS.

In a speech at the Improving Patient Safety and Care Conference this morning, the health and social care secretary stressed the importance of holding senior management accountable and ensuring they adhere to the highest standards.

Referring to scandals at Gosport War Memorial Hospital, Mid Staffordshire NHS Foundation Trust and Liverpool Community Hospital, he said:

‘Creating a more just culture in the NHS, a more open, honest and trustworthy culture, starts at the top.

Getting the right leadership is vital. We need more people with clinical backgrounds and more people from outside the NHS’.

Referring to the fit and proper person test (FPPT) review, led by Tom Kark QC and published today, he said:

‘Kark recommends that all directors must meet minimum competency standards to sit on the board of any health organisation.’

Mr Hancock stressed the need to tackle the high turnover at the top of organisation and hire ‘inspirational’ leaders.

But he also added that the Government will support senior leadership to meet these standards by providing them with the right training to lead their organisations and create a positive working environment.

He endorsed the setting up of a central directors’ database where information about directors’ qualifications and employment history can be accessed – as recommended in the FPPT review.

The review, commissioned by then health and social care minister Stephen Barclay in July last year and published today, assesses the test introduced in 2014 to determine the skills and qualifications of directors at NHS trusts and foundation trusts.

Improving patient safety was another core point in Mr Hancock’s speech. The health secretary explained that he wants to ensure staff have more time for patients and less paperwork to complete, and that there are faster resolutions for patients who have been wronged.

He also called for an end to the ‘morally abhorrent’ treatment of whistleblowers, adding that the NHS needs to change its culture from one of blaming people to one of learning from what is being said.

Mr Hancock said: ‘Whistleblowers are doing the NHS a great service. Someone, who has the courage to speak up and put their head above the parapet should be encouraged and embraced. Yet, sadly, all too often, they’re ignored, bullied and worse – forced out.

‘Making someone choose between the job they love, and speaking the truth to keep patients safe, is morally abhorrent and operationally foolish. It’s an injustice I am determined to end.’

Ensuring that the NHS operates with openness and transparency was also a cornerstone of the NHS long term plan, published last month.

The plan underlined the need to create an inclusive culture within the health service. It also set out measures to help more senior clinicians step into leadership roles.

The Kark review into the FPPT found that the test does not currently succeed in its objective to ensure directors are fit for the roles they hold.

Setting up a central database of directors’ qualifications was one of the seven recommendations set out in the review.

Other suggestions included expanding the FPPT to apply to all commissioners, and creating an organisation with the power to suspended and disbar directors found guilty of serious misconduct.

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