Health bosses won't be rewarded for failure under new regulations
Source: gov.uk (2025-07-20)

NHS managers who commit serious misconduct will not be able to take up other senior NHS roles, under plans to boost patient safety.

- Managers who commit serious misconduct will be banned under proposals
- Patients to benefit from proposals to professionalise NHS management
- Whistleblowers will be protected under new regulations
NHS managers who commit serious misconduct will not be able to take up other senior NHS roles, under plans to boost patient safety.

The new proposals set out by the Department of Health and Social Care will mean any leader who silences whistleblowers or behaves unacceptably will be banned from returning to a health service position.

They set out the first steps to meet the government’s commitment to introduce professional standards for, and regulation of, NHS managers, with legislation set to be put forward to Parliament next year.

Tens of thousands of clinical and non-clinical managers work in the NHS but there is currently no regulatory framework specifically for managers, like there is for doctors and nurses.

Wes Streeting, Secretary of State for Health and Social Care, said:

I’m determined to create a culture of honesty and openness in the NHS where whistleblowers are protected, and that demands tough enforcement. If you silence whistleblowers, you will never work in the NHS again. We’ve got to create the conditions where staff are free to come forward and sound the alarm when things go wrong. Protecting the reputation of the NHS should never be put before protecting patient safety.

I promised no more rewards for failure in the NHS, and these measures will deliver on it. Most NHS leaders are doing a fantastic job, but we need to stop the revolving door that allows managers sacked for misconduct or incompetence to be quietly moved to another well-paid role in another part of the NHS.

The reforms we are making through our Plan for Change (https://www.gov.uk/missions/nhs) will slam the door in the face of unsuitable managers, while providing the training, support and development to help NHS leaders thrive and lead the NHS into a brighter future.

Reviews by Tom Kark KC, General Sir Gordon Messenger and the Infected Blood Inquiry all highlighted the need for strong, transparent and accountable leadership.

The new proposals, developed following a public consultation (https://www.gov.uk/government/consultations/leading-the-nhs-proposals-to-regulate-nhs-managers), will strengthen health service leadership and professionalise NHS management as part of the 10 Year Health Plan (https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future).

The consultation, launched in November last year, received more than 4,900 contributions on ways in which managers and leaders could be regulated.

In response, the government will develop a proportionate regulatory system that focuses where need is greatest. It will ensure that those who have committed serious misconduct are no longer able to work in senior NHS management positions, preventing unacceptable behaviour and improving patient safety.

The statutory barring system will be for board-level directors and their direct reports within NHS bodies.

Further legislation will set out new statutory powers for the Health and Care Professions Council (HCPC) to disbar NHS leaders in senior roles who have committed serious misconduct.

Separate NHS England professional standards for managers will establish a consistent, national set of expectations about NHS management and leadership competency and conduct.

This follows last year’s announcement of a new college of executive and clinical leadership to attract, develop and keep the best talent in NHS leadership.

Regulation will come alongside support and development, with managers being given the tools they need to meet standards and succeed in their roles.

Sam Allen, NHS National Director for Leadership and Management, said:

The 10 Year Health Plan was clear about the huge importance of excellent leadership and management, both to the quality of patient care and staff experience now, and to how we deliver the plan’s ambitions for the future.

Managers will welcome this new regulatory framework, as part of the broader package of actions set out in the plan to attract, develop and retain the best possible leaders for the NHS of today and tomorrow.

Accountability is a crucial part of this, and can only boost trust with patients, the public and other professionals.

Tom Kark KC, author of the Kark Review (https://www.gov.uk/government/publications/kark-review-of-the-fit-and-proper-persons-test), said:

I am pleased that the recommendation made in my report into the application of the NHS fit and proper person test to create a power to disqualify board directors found guilty of serious misconduct is being implemented.

Along with the ongoing implementation of my other recommendations for improving board competence, this is a positive move to strengthen management in the NHS by weeding out poor leadership. This is good news for whistleblowers and those looking for accountability in senior management which has long been lacking.

Rachel Power, Chief Executive of the Patients Association, said:

Patients have told us they expect NHS managers to be held to the same high standards as clinical staff, and that should include consistent regulation. A clear, fair process to prevent those who commit serious misconduct from returning to senior roles will be an important step forward, and it’s vital that patient involvement continues to shape proposals as further regulation is considered.

We’re pleased to see a commitment to meaningful support and development for NHS managers, because the best way to address serious failings is to help prevent them from happening in the first place.

The proposals come as part of a package of essential reforms needed to rebuild the NHS so it is fit for the future through the government’s Plan for Change.