Regulating healthcare systems – Monitor
The inquiry made a series of recommendations about regulation and governance of NHS foundation trusts. This included making significant improvements in the way foundation trusts are authorised, based on local opinion, quality and sustainability.
These recommendations include provision for enhancing the role of foundation trust governors, and the accountability of board-level directors, ensuring directors are fit and proper persons for the role.
The NHS Trust Development Authority, the Care Quality Commission (CQC) and Monitor have already improved the foundation trust authorisation process to learn the lessons from the first Inquiry and ensure stronger focus on quality.
They are now undertaking a complete end-to-end analysis of the authorisation process and will embed the fundamental standards of care.
In addition, the CQC will inspect trusts prior to application, and no trust will go forward for authorisation unless, or until, it is rated ‘good’ or ‘outstanding’ under the CQC’s new inspection regime.
There will also be further improvement on capturing local opinion, including commissioners, patients and the public.
Monitor have also taken steps to strengthen the role of governors, issuing new guidance, setting up a panel for advising governors, and working with the NHS Leadership Academy and the Foundation Trust Network to provide a new national training programme.
In July 2013, the government issued a consultation on ‘Strengthening corporate accountability in health and social care’ which proposes that all board directors, or equivalents, of providers registered with the CQC must meet a new fit and proper person test.
Recommendation 80Disqualification of directors
Recommendation 81Experience and training as fitness criteria
Recommendation 82Removal of directors
Recommendation 83Monitor guidance on principles of exercising power
Recommendation 84Reporting of executive and non-executive contract termination
Recommendation 85Executive or non-executive director guilty of serious failure
Recommendation 86Training and continued development of directors