Monthly Archives: May 2014

How can the NHS eliminate risky behaviour with new proposals to make giving misleading information a criminal offence?

When the Care Bill comes into force in October, it will become a criminal offence for healthcare providers to provide false and misleading information; or for a director, manager , secretary to have ‘consented or connived in’ an offence committed by a care provider.

This proposed legislation follows recommendations that came out of the Robert Francis inquiry into the Mid Staffordshire Foundation Trust last year, which found that the Trust had made inaccurate statements about its mortality rates repeatedly.  At the Mid Staffordshire Foundation Trust senior managers had made serious errors of judgement, and failed to ensure that medical staff followed procedures properly, leading to safety breaches and high mortality rates. The inaccurate statements about the mortality rates were not the underlying cause of the problem.

The Department of health is currently consulting on these proposals, with the consultation process ending on 5th June 2014

If this law is passed, NHS Trusts will have to demonstrate they took “all reasonable steps” and exercised “due diligence” to provide accurate information and, according, to the consultation, it will be more difficult to demonstrate this if there are persistent errors. If healthcare providers are found guilty they will be fined or potentially face imprisonment for up to two years (or both).

To eliminate risk, people that directly or indirectly impact patient safety need to introduce a competency management system that provides evidence that everyone employed by the Trust fully understands the job that they do and that they are confident in the execution of their duties.

In both clinical and non-clinical environments and over the course of the last 20 years of delivering competency based assessments, we have found that up to 30% of any workforce, will unwittingly have a low enough level of understanding of their roles or the organisational policies and procedures to place the organisation (or their colleagues and patients) at significant risk. This is something that should send alarm bells ringing for healthcare providers about the need to improve the way they handle risk and compliance issues.

If this new legislation comes into force, it will be more important than ever for NHS Trusts to identify areas of risk, particularly with regard to employee understanding. Managers will need to identify where employee confidence is high and understanding is low and seek to eliminate risks using a variety of interventions.

The threat of potential imprisonment won’t solve the underlying problem if personnel lack the confidence, knowledge or understanding to do the job. Besides without a competency management system focused on People Risk you won’t have the due diligence needed in a court of law.

Assessing whether employees fully understand and comply with organisational processes will help embed patient safety into NHS culture, eliminate risk, give managers confidence that their staff are doing the right thing and enable staff to fulfil their full potential.

 

Co-operative Bank Members agree to reforms but needs to better manage employee competence, behaviour and overall People Risk

Co-operative Group members have unanimously voted in favour of overhauling the governance of the troubled 150-year-old British mutual following proposals from Lord Myners.

The decision, made at a special meeting in Manchester, will lead to a radical shakeup of the business after it suffered a “catastrophic failure of governance” and losses of £2.5bn in 2013.

The Co-op bank was once revered for its ethical policies and supposedly low risk behaviour, when others in the sector were knee deep in crisis. However, as Lord Myner’s review found, the bank is riddled with problems. He declared the current board was “manifestly dysfunctional” and that board members lacked business experience.  His proposals included replacing the Co-op’s 21-strong board of representatives with a slimmed-down structure of professionally trained directors.

In an interview with Sky News, Lord Myners said the bank’s crisis epitomised the scale of the incompetence he had witnessed. He said: “How the board of the Co-op two years ago thought it could acquire the branch businesses of LloydsTSB is beyond imagination and added that, “I cannot imagine a group of people less equipped, less competent, to own and control a bank.

This situation really begs the questions – how was employee competence measured at the bank if at all? How did people’s behaviour go unchecked? Why did the bank recruit Paul Flowers as Chairman?  He was a man with limited banking experience and in a previous role as a trustee of the drugs charity Lifeline; Flowers had resigned in 2004 after allegedly filing false expenses claims. Why then was he made Chairman of the sector’s ‘most ethical’ bank in 2010 and how has it gone unchecked that board members lack business experience?

Reputation is one of the most prized and also one of the most vulnerable corporate assets. Reputation risk caused by people is something the banking sector desperately needs to address, and something the Co-op seems to have been lost sight of over the years.

Urgent reforms are clearly needed at the Co-op Bank, but surely a priority must be to overhaul the recruitment process immediately and at the same time ensure that all current employees are assessed to ensure they are competent and behave in a way that adheres to the ethical standards and policies of the bank.

Better ways of managing competence from the top down must be prioritised as well as systems introduced to identify risky behaviour.  To recover from this crisis and restore trust, the Co-op has a long road ahead but upholding its values is crucial and this can only be achieved if its people are competent and behave in the right way.