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NEW INQUIRY: NHS Leadership, performance and patient safety

25 January 2024

The Health and Social Care Committee has launched a new inquiry to examine leadership, performance and patient safety in the NHS.

MPs will consider the work of the Messenger review (2022) which examined the state of leadership and management in the NHS and social care, and the Kark review (2019) which assessed how effectively the fit and proper persons test prevents unsuitable staff from being redeployed or re-employed in health and social care settings.

The Committee’s inquiry will also consider how effectively leadership supports whistleblowers and what is learnt from patient safety issues.

An ongoing evaluation by the Committee’s Expert Panel on progress by government in meeting recommendations on patient safety will provide further information to the inquiry.

Chair's comment 

Health and Social Care Committee Chair Steve Brine MP said:

“The role of leadership within the NHS is crucial whether that be a driver of productivity that delivers efficient services for patients and in particular when it comes to patient safety.

Five years ago, Tom Kark QC led a review to ensure that directors in the NHS responsible for quality and safety of care are ‘fit and proper’ to be in their roles. We’ll be questioning what impact that has made.

We’ll also look at recommendations from the Messenger review to strengthen leadership and management and we will ask whether NHS leadership structures provide enough support to whistleblowers.

Our Expert Panel has already begun its work to evaluate government progress on accepted recommendations to improve patient safety so this will build on that. We owe it to those who rely on the NHS – and the tax-payers who pay for it – to know whether the service is well led and those who have been failed on patient safety need to find out whether real change has resulted from promises made.”

Terms of Reference

The Committee invites written submissions addressing any, or all, of the following points, but please note that the Committee does not investigate individual cases and will not be pursuing matters on behalf of individuals.  

Evidence should be submitted by Friday 8 March. Written evidence can be submitted here of no more than 3,000 words.  

  • How effectively does NHS leadership encourage a culture in which staff feel confident raising patient safety concerns, and what more could be done to support this?
  • What has been the impact of the 2019 Kark Review on leadership in the NHS as it relates to patient safety?
  • What progress has been made to date on recommendations from the 2022 Messenger Review?
  • How effectively have leadership recommendations from previous reviews of patient safety crises been implemented?
  • How could better regulation of health service managers and application of agreed professional standards support improvements in patient safety?
  • How effectively do NHS leadership structures provide a supportive and fair approach to whistleblowers, and how could this be improved?
  • How could investigations into whistleblowing complaints be improved?
  • How effectively does the NHS complaints system prevent patient safety incidents from escalating and what would be the impact of proposed measures to improve patient safety, such as Martha’s Rule?
  • What can the NHS learn from the leadership culture in other safety-critical sectors e.g. aviation, nuclear?

Further information

Image: Creative Commons