Regulation of NHS Managers: Consultation Response

Karin Smyth Excerpts

Monday 21st July 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

Ensuring strong and accountable NHS leadership will be critical to delivering our plan for change and building an NHS fit for the future.

We know the important role that high-quality leadership plays in fostering a compassionate and transparent culture within the NHS and we want a healthcare system where staff feel confident to speak up, with a positive and open workplace culture.

The vast majority of NHS managers do an excellent job. They are also responsible for hugely significant decisions that affect patient care, and the Government believe that they should be held to the same high standards of accountability as the healthcare professionals who work in the NHS.

Too often, tragic cases and high-profile reviews have shown repeated instances where leaders have failed to act appropriately and have not been held to account for their actions. The Government are committed to ensuring NHS leadership is transparent and accountable. Today, the Department of Health and Social Care has published its response to the 12-week consultation on options for the regulation of NHS managers. This important development forms part of a programme of work to meet the Government manifesto commitment to introduce professional standards for, and regulation of, NHS managers.

Regulating managers will strengthen their professional accountability by providing a consistent and fair means of addressing concerns about conduct or performance, protecting the public by removing those from the profession whose conduct is unacceptable.

The consultation had a high level of engagement, with 4,924 responses, over 100 of which were from organisations. I would like to put on record my sincere gratitude to everyone who took the time to share their views on this pivotal piece of work.

Having considered these views, the Government will be bringing forward legislation to provide the health and care professions council with the powers to run a statutory barring system for NHS board level leaders and their direct reports so that those who commit serious misconduct or silence whistleblowers will not be able to practise in senior roles in the NHS. We will explore what further steps can be taken so that those barred from working in the NHS are not employed in equivalent roles in social care.

It is equally essential that managers and leaders are supported with the skills they need to deliver transformation in the NHS and that they can access development opportunities that enable them to meet the high standards that will be expected of them. This is why today’s consultation response builds on our wider programme of leadership and management development that will ensure patient, public and professional confidence in NHS leadership and equip the NHS with the leaders needed to deliver our 10-year health plan. This programme of leadership reform, designed to strengthen the capability, confidence and accountability of NHS managers includes the establishment of the college of executive and clinical leadership. As part of our work to develop the college, we will work with stakeholders to consider whether there are forms of accreditation that could be implemented to recognise the professionalism of NHS managers and leaders. This will be complemented by wider work to strengthen NHS leadership, including NHS England’s leadership and management framework, the NHS very senior manager pay framework, and the implementation of General Sir Gordon Messenger’s recommendations to establish a national and regional strategic approach to talent management in the NHS.

The consultation also asked about the introduction of a professional duty of candour for NHS leaders, if leaders should be under a duty to ensure that the existing statutory (organisational) duty is correctly followed in their organisation and about the responsibility of leaders to respond to patient safety concerns.

These issues have been highlighted in previous reviews and inquiries including the 2019 Kark review, the 2024 infected blood inquiry and the Thirlwall inquiry into events at the Countess of Chester hospital. This consultation response reinforces the responsibility of leaders and managers in relation to candour and patient safety. As we implement regulation of managers, take forward recommendations from the IBI and consider the implications of the Cabinet Office’s proposed Hillsborough law, we will consider what further sanctions may be required in relation to failing to uphold the principle of candour.

Next steps

Department officials will prepare draft legislation to provide the HCPC with the powers to implement a statutory disbarring regime for NHS managers. When parliamentary time allows, we intend to bring forward this legislation, which will be subject to a further public consultation. We will continue to engage with stakeholders throughout and we will work closely with NHS England to ensure alignment with the wider work under way to develop and professionalise NHS managers and leaders.

[HCWS873]