NHS managers who silence whistleblowers to be banned from senior health roles
Tens of thousands of clinical and non-clinical managers work in the NHS but there is currently no regulatory framework specifically for managers, as there is for doctors and nurses.
Health Secretary Wes Streeting said the reforms will 'slam the door in the face of unsuitable managers'.
Mr Streeting added: 'I'm determined to create a culture of honesty and openness in the NHS where whistleblowers are protected, and that demands tough enforcement.
'If you silence whistleblowers, you will never work in the NHS again.
'We've got to create the conditions where staff are free to come forward and sound the alarm when things go wrong. Protecting the reputation of the NHS should never be put before protecting patient safety.
Health Secretary Wes Streeting said those who silence whistleblowers 'will never work in the NHS again' (PA)
'Most NHS leaders are doing a fantastic job, but we need to stop the revolving door that allows managers sacked for misconduct or incompetence to be quietly moved to another well-paid role in another part of the NHS.'
DHSC said a public consultation launched in November last year received more than 4,900 contributions on ways in which managers and leaders could be regulated.
The statutory barring system will be for board-level directors and their direct reports within NHS bodies.
Further legislation will set out new statutory powers for the Health and Care Professions Council to disbar NHS leaders in senior roles who have committed serious misconduct.
Separate NHS England professional standards for managers will establish a 'consistent, national set of expectations about NHS management and leadership competency and conduct', DHSC said.
Tom Kark KC, author of the Kark Review into the effectiveness of the fit and proper person test within the NHS, said: 'I am pleased that the recommendation made in my report into the application of the NHS fit and proper person test to create a power to disqualify board directors found guilty of serious misconduct is being implemented.
'Along with the ongoing implementation of my other recommendations for improving board competence, this is a positive move to strengthen management in the NHS by weeding out poor leadership.
'This is good news for whistleblowers and those looking for accountability in senior management which has long been lacking.'
Rachel Power, chief executive of the Patients Association, said patients expect NHS managers 'to be held to the same high standards as clinical staff, and that should include consistent regulation'.
Ms Power added: 'A clear, fair process to prevent those who commit serious misconduct from returning to senior roles will be an important step forward, and it's vital that patient involvement continues to shape proposals as further regulation is considered.'
Sam Allen, NHS national director for leadership and management, said: 'Managers will welcome this new regulatory framework, as part of the broader package of actions set out in the plan to attract, develop, and retain the best possible leaders for the NHS of today and tomorrow.'
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Sky News
32 minutes ago
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'It destroyed my life': The drug addiction leaving users in chronic pain
Nicole will always remember the first time she took ketamine. It was the start of a night out and she didn't want to drink. So instead, she picked up the bag of white powder she found in her friend's car. It was a decision that had life-altering consequences. "I tried it and remember having it and just thinking, this is it," she recalls. "This is my saviour. This is my drug." Instead of rescuing her from her mental health struggles like she hoped it would, ketamine sent her into a spiral. Less than four years on, the 31-year-old mother of one from Southport is now living in a detox centre, separated from her son and living in chronic pain. 9:33 Nicole's journey from recreational use to a deep addiction that caused her severe bladder and kidney problems may be just one extreme case, but ketamine use is now at record levels. Experts believe this could cause a tidal wave of issues the country is not prepared for, placing severe pressure on the NHS, as well as addiction and mental health services. Currently a Class B drug, ketamine is used in clinical settings as an anaesthetic for people and animals. It is usually taken recreationally as a crushed powder, but also sometimes injected or swallowed - making people feel detached and dreamlike. Referred to as "ket" and "special k", it's easily available and costs around £30 a gram. Between 2023 and 2024, the number of children and young people who reported having a problem with the drug surpassed cocaine for the first time. The number of ketamine deaths in England and Wales also increased from seven in 2015 to 53 in 2023. 'I don't remember the last three years' I met Nicole at Birchwood, a residential drug and alcohol detox facility on the Wirral. In the week before I arrived, 14 out of 25 beds were taken by ketamine users. As we walk through the corridors, Birchwood manager Jo Moore tells me that in more than two decades of working in healthcare, she's never dealt with a challenge as big as the wave of people she's seeing addicted to ketamine, arriving with extreme and complex health issues. "They're all presenting with urinary incontinence, some can't even walk, they've lost their muscle tone, some are in wheelchairs, and the crippling pain they're going through is significant," she says. As well as running Birchwood, Jo speaks about the drug at conferences and holds a weekly video call, offering support for a growing group of parents whose children are addicted. I also met Callum, who describes himself simply as "just a lad from Cheshire ways". While speaking, he often pauses for thought, struck by how quickly his life has taken a turn since his addiction began three years ago. When his dad died following a struggle with alcoholism, Callum, who had been his carer, turned to ketamine. Until then, the 24-year-old had only taken the drug at festivals, but it quickly took over his life. "I was so out of it constantly," he says. "I don't remember the last three years properly because of just, you know, you've taken it the whole time." Daily use nearly cost Callum his life. He had multiple organ issues and weighed just six stone by the time Jo, who knew his family, told his mother that he needed to come to rehab. Callum's experience is a reminder of how hard it can be to break a dependency on ketamine. As an anaesthetic, it creates a vicious cycle. Users need it to help ease the pain it causes them. "It's only once you get off the ketamine you realise the pain that you've got and the problems that you've got," Callum tells me. "When you're on it, you know you've sort of got pains, but you don't think they're that bad. "People I know drank for 30, 40 years and my liver is worse than theirs, just from ketamine alone." 'Ketamine destroyed my life' Nicole also turned to ketamine because it felt like a way out. She'd had a difficult childhood, been in an abusive relationship as an adult and struggled with mental health issues her whole life. In a moment of blunt honesty, she tells me she does not regret taking ketamine. "If I didn't take ketamine in that period of time, I wouldn't be here," she says. "It was a coping mechanism for a while, before it destroyed my life." As her bladder and kidneys deteriorated, Nicole was taken to hospital several times, often treated by medics who could not understand the problems caused by heavy ketamine use. On one occasion, she was sent home with chlamydia tablets. On another, she had an invasive kidney procedure with no anaesthetic, because doctors were concerned about giving her pain relief due to her ketamine use. Becoming more animated, Nicole tells me: "To be in that situation where you need help, you don't know what's going on yourself, the only place you can go to is the hospital and not even they know what is going on with you. That is like a complete state of isolation, loneliness." Nicole now starts her days in severe agony. She says the chronic pain will last the rest of her life, and pauses at one point in conversation to tell me her bladder is spasming as we speak. Despite how difficult the last few years have been for them, Nicole and Callum both have hopes for their lives beyond Birchwood. In the months after I met him, Callum successfully completed his detox and rehab. He has also made good on a promise to "get his life back on track" by finding a full-time job. Things have been more difficult for Nicole, who is still in Birchwood and has been in and out of hospital for a range of bladder and kidney complications. She is still waiting to find out whether her bladder will be removed. Nicole has made it her mission to raise awareness, posting regularly on TikTok about her appointments and her day-to-day life. Her ultimate hope is to one day join Jo in delivering talks across the country about the drug and its dangers. Life-changing injuries within a year Away from Birchwood, the struggles of people like Callum and Nicole are also being felt in the NHS. Alison Downey is a consultant urologist at Pinderfields Hospital in West Yorkshire, where "ketamine bladder" has become an increasingly common phrase to describe the severe damage the drug can do. "We've seen an explosion in numbers over the past, particularly two to three years," she says. "Maybe about four or five years ago we would have one or two cases a month, we're now seeing eight or nine a month." 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That can result in needing to go to the toilet every 15 to 20 minutes throughout the day or night." Framing the issues being seen on the frontline are the ongoing discussions around reclassification. Earlier this year, the government announced it would look into the possibility of making ketamine a Class A drug, which would carry greater penalties for making and selling it. Dr Caroline Copeland is a senior lecturer in pharmacology and toxicology at King's College London and also the director of the National Programme on Substance Use Mortality. For her, this debate is nuanced and needs to go beyond criminalisation. "I think that instead of necessarily focusing on the punitive measures, which is what comes with the reclassification, we need to be thinking more about how we can actually spend that time and money towards helping the people who are using ketamine and education programmes to stop people starting to use ketamine in the first place," she said. 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