Friday before the Bank Holiday, NHSE dropped a press release.
Management by knee-jerk.
Amanda Pritchard, NHSE boss announced ‘an urgent meeting’ to get something or other under-way, to regulate managers.
A hair-trigger response…. look busy after the welter of bad publicity at the Countess of Chester.
Management in the frame.
Pritchard seems to have overlooked the facts:
• the CEO was a former nurse, and well-knew the principals of professional integrity.
• The nursing director is on the NMC register.
• The medical director regulated by the GMC.
Forgotten;
• a third of NHS management posts are held by regulated clinicians.
… and now the unwitting (?) cheer leader for the Labour Party who without any thought, have jumped on the band-waggon.
Parking that. Let’s think about management by jumping-over-the-edge.
We’re all hard wired to react, with a built in negativity bias. ‘Something is wrong, I have to fix it’.
Prichard’s meeting is a bad idea…
… it is powerless to achieve anything. The components for regulating senior managers exist… and in the gift, only, of the DH+ and Parliament.
We know why she’s doing it… looking busy and ‘on-it’.
People are distracted enough, trying to recover from the last strike and getting ready for the next one.
We can do without more distractions, Zombie meetings and vanity emails.
The threat of knee-jerk, cack-handed regulation is deeply demoralising, particularly as the regulation we have now demonstrably, doesn’t work.
To spell it out:
• Regulation was first ‘a topic’ in High Quality Care for All 2008, dumped by the coalition.
• The framework for a regulatory regime is ten years old. The Fit and Proper Person Test as it applies under Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Reports into previous NHS disasters, Francis, Kirkup, Kark all recommended accountability for senior managers. Getting shot of the bad ones and preventing them from ‘revolving door’, back into top jobs.
• HMG, in it’s ‘Hard Truths’ response to Francis promised; ‘a new, stronger Fit and Proper persons test for Board level appointments… [enabling] the CQC to bar directors who are unfit’… it never happened.
• In 2018 the DH+ convened a meeting about regulating managers and later dropped it.
A couple of weeks ago, five years after Kark, NHSE got around to planning a strengthened FPP framework… including;
• specified standards of competence for board directors, but not until next year;
• an appraisal system, not until next year;
• a database of directors (no, there isn’t one);
• mandatory references for each director, (no there aren’t any);
• the FPPT to include the NHSE and CQC.
Why has it taken this long?
Dunno…
Right now the desirability and the practicality or otherwise of regulating senior managers is an empty debate. None of it in the gift of NHSE. Nor should it be.
The parents want their day in the inquiry. Have a say in the future. They don’t want Pritchard & Co second guessing, prejudicing the outcome and deciding for them.
In a blatant, clumsy, stupid power grab, Pritchard said she wanted to explore;
‘… the feasibility of NHSE being given the powers and resources to act as a regulator.’
Absolutely not! No, no. no, no, no.
The parents certainly won’t want managers regulating themselves… and that rules out the CQC, as well.
If this has come from the NHSE Board they need to think about the optics, read up on the history and focus on the day job.
If this is the DH+ pulling the strings, say so… tell them to … off!
Ministers should want to await the outcome of the Inquiry. Second guessing, is to undermine and confer an irrelevance on their work … ‘why give evidence, they’ve already made up their minds’… is what the public will say.
Decisions about regulation will define the NHS for a generation, implicate resource management and how risk is managed.
Regulation doesn’t mean accountability… managers are accountable now, to directors. Directors to Boards and Boards to ministers.
Regulated staff accountable to regulators and regulators to…. privy-councillors… who are MPs.
None of it works. It all needs demolishing. Starting again.
In addition to FPPT there’s;
• Statutory duty of Candour
• Freedom to speak up
• New guidance simplifying the incident investigation process
• Changes to CQC inspection regime
• Sign up to Safety
• Medical examiners
• Whistleblowing mechanisms…
… Pritchard & Co have failed to make this work and instead preside over a toxic environment where no one feels free to speak truth to power.
It is long overdue for senior leadership to reinvent openness, values driven management…
… demolish cliques and fiefdoms. Promoting patients from bit-players to centre stage.
NHSE’s job is to fix all that… be conscious of what we do and how it looks.
Fatuous, strident comments like this do nothing to help;
An NHS England spokesperson said: “NHS guidance is clear, staff should be supported to raise concerns and that these are acted on.
Pretty obviously, they are not, being supported!
If NHSE’s only response is to reach for power and regulation, the time has come for much better leadership…
With thoughtfulness and a soft voice.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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