Kark review raises questions about NHS workplace culture

The government has accepted in principal two of the recommendations to come from the Kark review of the of the fit and proper persons test, in order to make sure senior NHS leaders are fit for their posts.

The Kark Review, by Tom Kark QC and commissioned by former Minister of State for Health Stephen Barclay, includes 7 recommendations for how the government can better support NHS senior leaders to deliver high-quality and safe care in the NHS.

Of these recommendations, the government has accepted in principle to set up a central database of information about the qualifications, previous employment and performance of directors, and;

To make new competency standards to help people know what to expect of senior managers.

The remaining recommendations will be considered as part of the workforce implementation plan later this year, which will be led by Baroness Harding, chair of NHS Improvement.

An independent investigation by the Parliamentary and Health Service Ombudsman concluded the Care Quality Commission, which must oversee the appointment of NHS directors, had not used the NHS ‘fit and proper’ person test when Paula Vasco-Knight was given the role of acting chief executive at St George’s University Hospital NHS Foundation Trust in London in 2016.

Vasco-Knight was given a suspended sentence in 2017 after she was found to have paid her husband NHS funds for fictitious work while she was chief executive at Torbay NHS Trust. She had to resign from her role as chief executive of the Devon trust in 2014 after a tribunal suspended her for bullying a whistleblower. The person accused her of nepotism, when she employed her daughter’s boyfriend.

Secretary of State for Health and Social Care Matt Hancock spoke to healthcare professionals at the Royal Society of Medicine.

“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,” said Hancock. “Yet sadly, all too often, they’re ignored, bullied and worse, forced out.”

Danny Mortimer, chief executive of NHS Employers, said: “The recognition by the secretary of state of the steps the NHS must take to develop a just culture in which we encourage learning from mistakes will be welcomed by all of our staff.”

Beth Hale, partner and general counsel at CM Murray, said Hancock’s speech was indicative of a “general cultural push” across sectors to make sure whistleblowing was encouraged. She told People Management:

“It goes beyond the NHS – there’s definitely a move to make sure people feel able to speak up where there are things that are not being done properly or things that are going wrong within organisations,” she said.