Practice managers in England will not be included – for now – in new government regulations covering NHS managers, though this may change due to an ‘appetite’ to expand the scope, according to the Department of Health and Social Care (DHSC).
The new regulatory framework, announced last week, introduces a statutory barring system preventing NHS leaders guilty of serious misconduct from taking on other senior roles in the health service. Its aim is to protect whistleblowers and improve patient safety, with legislation expected to go before Parliament next year.
While the regulations will initially exclude primary care, the DHSC has indicated this may change.
The proposals follow a public consultation between November 2024 and February that explored ways to increase the accountability of NHS managers and leaders.
It suggested that NHS managers could be regulated under mechanisms similar to those for medical and nursing colleagues.
The consultation also sought views on whether regulation should extend to those delivering NHS services, such as in primary care, social care, and independent providers working under NHS contracts.
The government said that the consultation, which received more than 4,900 contributions, showed ‘appetite’ to extend the scope of regulation to include primary care and the private sector.
However, there was also strong support for starting with a narrower cohort of managers, starting with senior NHS managers, and then ‘rolling out to further levels of management over time’.
As a result, the government will initially introduce regulation with a statutory barring system for board-level directors and their direct reports within NHS bodies. The NHS bodies are expected to include NHS trusts, foundation trusts and integrated care boards (ICBs).
The DSCC said that it would review the regulatory system ‘once fully embedded’, with a view to ‘considering whether the regime should be extended’.
Last month, doctors’ leaders called for all NHS managers, including GP practice managers, to be subject to statutory regulation and be required to demonstrate they are competent to work in their role.
BMA representatives discussed the issue at their annual representative meeting and called for a statutory register to be created for all NHS managers.
The new government regulations follow high-profile reviews including those by Tom Kark KC, General Sir Gordon Messenger, and the Infected Blood Inquiry, which all called for more transparent, accountable NHS leadership.
Health Secretary Wes Streeting said he was determined to ‘create a culture of honesty and openness in the NHS’ and that it demanded ‘tough enforcement’.
Meanwhile, separate NHS England professional standards for managers will introduce a consistent, national framework for leadership conduct and competence.
