One week to go before new NHS regulations to improve openness and transparency are enforceable

Published: 20 November 2014 Page last updated: 12 May 2022
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Today (20 November) marks the publication of guidance for NHS organisations to help them meet the requirements of new regulations that come into force next week.

The duty of candour and fit and proper persons requirement for directors come into force in a week’s time on Thursday 27 November for NHS Trusts, Foundation Trusts and some special health authorities that provide care and treatment that are regulated by the Care Quality Commission (CQC).

The guidance makes it clear how CQC will decide if NHS organisations are meeting the two new regulations.

We also today publish the response to the consultation that helped shape our provider guidance.

Professor Sir Mike Richards, Chief Inspector of Hospitals, said: “The guidance marks an important milestone to encourage a more open and transparent culture in the NHS.

"It is essential that CQC uses these new powers to hold providers and directors to account when care fails people, so that standards continue to improve.

“All registered providers must demonstrate that they are meeting these requirements to register with CQC and then continue to provide regulated services.

"This guidance will help us to determine whether there is a breach of regulations and if so, what action to take. In some cases, this will mean we will use our powers to prosecute.

“We will expect all providers to comply with them when they come into force in the NHS from next week.”

Sue Covill, director of employment services at the NHS Employers organisation, said: "We are pleased to see the guidance published today by CQC for NHS providers. NHS organisations will be reflecting on this before the new regulations come into effect next week and will be reviewing how both the duty of candour and fit and proper persons requirement will be assessed by the CQC.

"The new regulations present an opportunity for providers to show the robust processes that they have in place for recruiting and employing their Board level directors. To achieve the desired intention it important that the requirements do not just become another set of tick boxes but create the platform in which values-based leadership is encouraged and open, honest conversations are the norm. These are vital if we are to support NHS leaders in creating the right culture for high quality care to thrive.

"NHS Employers looks forward to working with the CQC over the coming months to review and reflect on the new requirements and ensure they achieve the desired impact of increasing openness and transparency for the benefit of patients."

The introduction of a statutory duty of candour for providers is an important step towards ensuring there is an open, honest and transparent culture; particularly when things go wrong.

During our inspections, we assess whether a provider is delivering good quality, safe care. As part of our approach, we ask whether lessons are learned and improvements made when things go wrong, including whether people who use services are told when they are affected by something that goes wrong, given an apology and informed of any actions taken as a result.  Where we find that the provider is not delivering good quality care, we consider whether a regulation has been breached.

CQC will assess whether systems and processes are in place to support the duty of candour, and will review evidence of what happened after a sample of incidents which resulted in significant harm to a patient. We are likely to ask if the provider told the relevant person about the incident, whether they provided a true account of what happened, and if they offered an apology.

The fit and proper person’s requirement – which applies only to NHS board members – is to make sure that providers have robust systems in place to carry out appropriate checks before a job offer or appointment is made. This would include whether the person is of good character, is physically and mentally fit and has the necessary qualifications, skills and experience for the role.

During registration, we will check that the provider understands the requirements of this regulation and ask them what systems they have in place so that they can meet it. It is for providers to identify that NHS board members are fit and proper persons, not CQC.

We will include details of how providers are meeting the two new regulations in our inspection reports.

The duty of candour and fit and proper persons requirement for directors are part of new fundamental standards of safety. The remaining fundamental standards will come into force from April 2015.

The duty of candour and the fit and proper persons requirement for directors will also be extended to all other providers from April via additional regulations, still subject to Parliamentary approval.

For media enquiries about the Care Quality Commission, please call the CQC press office on 020 7448 9401 during office hours or out-of-hours on 07917 232 143. For general enquiries, please call 03000 61 61 61.

Ends

The guidance marks an important milestone to encourage a more open and transparent culture in the NHS.

Professor Sir Mike Richards, Chief Inspector of Hospitals

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.