A Step Towards Real Accountability
In November 2024, the Government launched a Consultation regarding proposals for regulation of managers in the NHS (Leading the NHS: proposals to regulate NHS managers – GOV.UK).
The Consultation arose as a result of a number of Public Inquiries, but the accountability of managers was a key issue within the recent Thirlwall Inquiry, investigating the actions of former neonatal nurse Lucy Letby and systemic failings at the Countess of Chester Hospital.
The arrest of some of the managers from the Countess of Chester Hospital on suspicion of gross negligence manslaughter only highlights concerns present around their conduct.
The Consultation and Its Outcome
The Government Consultation has now concluded and it has been confirmed that, as a result of the responses that were received, there is going to be legislation introduced ‘to provide the Health and Care Professions Council the powers to run a statutory barring system for NHS board level leaders and their direct reports so those who commit serious misconduct or silence whistleblowers will not be able to practice in senior roles in the NHS.’
Bond Turner’s Role in Shaping Reform
We at Bond Turner played a pivotal role in the Consultation process by submitting our response to the Government. As legal representatives of some of the families involved in the case against Lucy Letby, and after listening to the evidence heard at the Thirlwall Inquiry, it was clear that changes within the NHS, and regulation of its managers and senior members, were desperately needed. We are of the view that the senior leadership team at the Countess of Chester Hospital were a clear and problematic obstacle when trying to identify the crimes of Lucy Letby.
When submitting the response to the Consultation, we had the interests of our clients and the knowledge of what we had learnt from the Inquiry at the very forefront. Thus, we were in a privileged position and were able to consider in depth as to how real change could be made. It was clear to us that the NHS was in need of consistent, strong and accountable leaders, who encapsulated the Duty of Candour and the Freedom to Speak Up, as well as ensuring a positive and transparent workspace. This would then feed into the hospital environment as a whole and would have a huge impact on patient safety. We felt the only way to create this type of leader would be through training and regulation. They ought to be professional people who should have to keep up to date on developments and maintain a high level of conduct.
Doctors and nurses both have regulatory bodies, therefore it did not make sense that NHS managers were not regulated in a similar capacity, given the decision-making powers they hold and the importance of their positions. Thus, we felt it was imperative that they were held to the same account as other professionals, and this was put forward by us as part of the Consultation process.
As a result, the Government recently announced that they will implement legislation to provide the Health and Care Professions Council with the powers of regulation and to run a statutory barring system for NHS board level leaders. In addition, they will explore steps that could be taken so that those barred from working in the NHS cannot be employed in any other roles in social care.
Raising Leadership Standards in the NHS
Whilst the statutory disbarment is essential, there is also a need for NHS managers to access training and development opportunities, so that they are able to meet the high standards expected of them. As such, the Government now also hopes to reinforce the responsibility of leaders and managers in relation to the Duty of Candour and patient safety.
There have been significant challenges in regard to the Letby cases, however the decision from the Government is welcomed as genuine positive change for the future of the NHS. We hope that further changes will be implemented following Lady Thirlwall’s report in early 2026.
It is not often we get to see real change within the NHS systems, and we are incredibly proud that our work has played a part in this significant change.