What’s behind Kark’s Fit and Proper Person Test review? Leadership and patient safety.

On 6 February the Secretary of State for Health and Care spoke to healthcare professionals at the Royal Society of Medicine. This coincided with the publication of the Kark review into the Fit and Proper Person Test.

While Matt Hancock said he was sorry to those families in Gosport, Liverpool Community Hospital, Mid Staffs and elsewhere, he said he was not there to point the finger, but was there to ensure we learn the right lessons. 

He observed that the fact of a mistake is not the biggest problem – it is how we respond to them. He is concerned that the growing number of clinical negligence claims threatens to swallow up the £20.5 billion being put into the NHS and threatens to derail the Long Term Plan. Hence, he spoke of a moral and financial urgency to act.

He referenced the new patient safety strategy and observed that creating a more just culture, a more open, honest and trustworthy culture, starts at the top. So getting the right leadership is vital.

Tom Kark’s review was something recommended by Dr Bill Kirkup in his report into the problems at Liverpool Community Health. Our earlier blog post on the review has more details from an employment law perspective.

However, it is also interesting to note the specific references made by the Kark review to learning and candour:

• Kark recommends a focus on discouraging behaviour which runs contrary to the duty of candour.
• He notes that CQC guidance already suggests that failing to learn from incidents, complaints and when things go wrong might constitute past mismanagement.
• In terms of core competencies for directors, he recommends these include a knowledge and understanding of:
  • Patient safety and medical management
  • Recognising the importance of information on clinical outcomes
  • Response to serious clinical incidents and learning from errors
  • Complying and encouraging compliance with the duty of candour
• With regard to a definition of serious misconduct, he recommends that this includes issues such as:
  • Causing, facilitating, colluding in or requiring any staff member to fail to comply with the duty of candour, including by means of a settlement or confidentiality agreement.
  • Causing, facilitating or colluding in the reckless mismanagement of an organisation resulting in the compromise of patient safety.
  • Without reasonable excuse, failing to provide records, data, information or evidence to legitimate statutory or government directed inquiries, reviews or investigations.