A management code of conduct must contain more than good intentions (HSJ, 5 March 2025)

Summary

The regulation of NHS managers must drive real change by addressing root causes, prioritising patient safety, and ensuring accountability without repeating past failures, writes Roger Kline in this HSJ article.

Content

Principles a code might adopt should include: 

1. Make safety the prime litmus test for all initiatives and “stop the line” (from board to ward and community setting) when it is not.
2. Make speaking truth to power a precondition of effective leadership.
3. Prioritise the duty of care all staff owe.
4. Expect and support managers (and staff) to always behave respectfully to each other (and to patients) and to relentlessly seek to create a culture of psychological safety, civility and inclusion, not least by leaders and managers modelling the behaviours they should expect of all staff;
5. Cease performative measures to tackle toxic cultures. 
6. Employer legal proceedings involving staff who have raised concerns should also be regarded as a “never event” and all costs disclosed. Employers must review at pace (with independent support) all cases of staff who have left or been dismissed after raising concerns with a view to helping them gain NHS employment;
7. Appointment and appraisal decisions.
8. Openness and transparency. 
9. Duty of candour. 
10. Specifically regarding as a breach of the Code “never events”.