Health regulator ‘lacks rigour in overseeing NHS director appointments’

18 Jan 19

The appointment of a convicted fraudster to a top NHS role showed the health and social care regulator lacked “rigour” in regulating the choice of NHS directors, according to a watchdog.

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.

The Parliamentary and Health Service Ombudsman report accused the Care Quality Commission of poor record-keeping, in the Vasco-Knight case, and said the CQC “lacked rigour in its regulation and of the appointment of NHS directors”. It had also failed to take a “transparent and proportionate approach”, in the Vasco-Knight case, it added.

The whistleblower, Clare Sardari, said the NHS trust prevented her from returning to work after raising the alarm about its chief executive. 

She said: “The reprisals against me and the inadequate investigation into my concerns by my former NHS trust and the chief executive were devastating for me and my family. The CQC acted dishonourably by trivialising whistleblower retaliation in its handling of my case.”

Rob Behrens, the Parliamentary and Health Service Ombudsman, said the case showed the CQC’s approach to employing directors “needs reviewing”.

“The public and NHS staff must have confidence that NHS leaders are fit and proper to do the job and that whistleblowers will not be penalised for raising concerns,” he explained.

“We need fair, transparent and proportionate oversight that stops leaders who have committed serious misconduct from moving around the NHS, and makes them accountable for their actions.”

Ian Trenholm, chief executive of the CQC, said: “We recognise that the handling of this case – both by CQC and by wider NHS organisations – did not meet Ms Sardari’s expectations of how the fit and proper persons requirement should operate, and acknowledge her frustration and distress.”

He added: “We do have concerns about the approach adopted by the ombudsman, which led to some of the findings of maladministration”.

In November, health secretary Matt Hancock stated he wanted to see whistle blowing encouraged in the NHS.

The National Audit Office recently warned that the NHS’s finances are unsustainable.

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