Response to UK Government consultation on Leading the NHS: proposals to regulate NHS managers

We have submitted our response to the Government’s consultation: Leading the NHS: proposals to regulate NHS managers

The call for regulation of NHS managers has accompanied multiple inquiries and reviews over several decades. But any action needs to be proportionate, targeted and based on a clear understanding of the problem being addressed. Crucially steps should be taken to enhance professional development as well as accountability. This is what PSA’s Chief Executive, Alan Clamp, outlined when he gave his evidence in January 2025 to the Thirlwall Inquiry

The UK Government’s consultation sets out three options for regulation of NHS managers, each has merits and drawbacks. 

1. A statutory register could raise standards and provide a way of excluding people who have fallen far short, but can be relatively inflexible, and would take time to introduce. 
2. A barring model offers flexibility but would also require legislation and not contribute significantly to raising standards. 
3. Voluntary registration could quickly improve standards and protect patients but would not have the same statutory powers to exclude people from the workforce. That said, if registration became an NHS requirement for holding specific posts, assurance would be bolstered. We would also suggest that any voluntary register was also accredited by the PSA for independent assurance this provides. An accredited voluntary register could also be a staging post on the way to statutory regulation.

The consultation on the regulation of NHS managers is a very useful first step on the way to finding the right solution. We agree with the Government that our right-touch regulation principles should guide the selection of the most appropriate regulatory model. This approach should help to establish the nature and scale of unmanaged risks to identify effective regulatory measures. What is also clear is that any approach should be developed in partnership with the sector, managers, healthcare professionals, and patient groups.