Is CQC’s handling of Regulation 5 “Fit and Proper”?

By Dr Minh Alexander NHS whistleblower and former consultant psychiatrist 21 November 2016

CQC has today admitted that St George’s trust’s approach to Regulation 5 Fit and Proper Persons (FPPR) is “ineffective”. CQC advises that it has issued the trust with a warning, for which a reply is required by 30 November. However, questions remain about CQC’s handling of FPPR at St George’s and why CQC shut down an FPPR process on Paula Vasco Knight.

CQC’s handling of Regulation 5 has been discredited to the extent that Robert Francis has now publicly admitted that FPPR is not working, and he has opened the door to possible managerial regulation. [1]

The CQC has delayed inordinately in responding to a referral on Paula Vasco-Knight, made under Regulation 5 Fit and Proper Persons, on 12 October 2015.

The referral related to her recycling to a board position, as chief operating officer at St. Georges, after her previous fall from grace due to a whistleblower scandal at South Devon Healthcare NHS Foundation Trust. [2] [3]

Behind the scenes, the CQC in fact quietly shut down the FPPR process in February this year. Mike Richards CQC Chief Inspector wrote to St George’s on 16 February to advise that the CQC had concluded that the trust’s FPPR process had been “thorough”. This letter only came to light in April through a disclosure by St. George’s itself. Mike Richards wrote:


The full letter is here:  cqc-fppr-closure-letter-vasco_knight-re-pvk-16-02-16

After being cleared thus by Mike Richards, Paula Vasco-Knight was promoted to chief executive, only to be removed within two weeks in relation to financial allegations. [4] St. Georges initially announced that she had been ‘suspended’ but later admitted that it had terminated her agency contract on the same day. Paula Vasco-Knight and two co-accused are scheduled for a two week trial in the Crown Court in January. [5]

Despite reminders, the CQC has taken until now to respond to the original, outstanding FPPR referral. It had this to say today:


The full letter is here: fppr-outcome-letter-cqc-21-november-2016

This raises questions about why Mike Richards concluded in February that St. George’s FPPR process was sound, and why the failings that are now acknowledged were not previously identified. Did the CQC previously only rely on what it was told by the trust? Have other FPPR referrals been mishandled by CQC due to lack of thorough checking? Why has CQC reduced FPPR to a bureaucratic exercise about compliance with process, and less about whether the right judgment was made?

The recycling of senior managers who have harmed whistleblowers sends the worst possible message to the NHS workforce, and gives licence to would-be abusers.

A letter about these issues by Clare Sardari South Devon whistleblower to St George’s governors can be found here:

Click to access clare-sardari-open-letter-st-georges.pdf

Clare Sardari tweets at @SardariClare

A complaint has now been made to the CQC about the handling of the matter, including the failure by CQC to disclose in February that it had closed down the FPPR process.

Given CQC’s comment in its latest letter that Paula Vasco-Knight was not directly employed by St. Georges but via an agency, CQC has also been asked to clarify whether it will apply FPPR equally to interim directors who are not directly employed by trusts.



CQC’s Fit and Proper Parade

This summarises the history of the controversy surrounding CQC’s prosecution of FPPR and provides relevant documents and correspondence.

Silent Knight

Clare Sardari’s correspondence with Robert Francis.



[1] Robert Francis calls for regulation of senior managers. Health Service Journal Shaun Lintern 9 November 2016

[2] Ex Torbay Hospital worker awarded £230,000 compensation after ‘nepotism’ row, HE Paul Greaves, Herald Express 19 July 2015

[3] Devon Health boss Dr Paula Vasco-Knight resigns, BBC 30 May 2014

[4] Health boss Paula Vasco-Knight suspended over finance claims, BBC 4 May 2016

[5] Former South Devon NHS boss denies £20K fraud

7 thoughts on “Is CQC’s handling of Regulation 5 “Fit and Proper”?

  1. I agree with the eloquence of dms91.
    How can those who are not fit and not proper judge who is? That’s like a goldfish making a judgment on a mammal.
    These creatures have no shame – and I’m not referring to the either the goldfish or the nearby mammal..


    1. The more they say, the more alarmed I am.
      They have a genuine difficulty in understanding what their function is. They don’t seem able to distinguish between what occurs in their little bubble of experience and the real world of suffering.
      I am appalled,


  2. Do what you say you do or dont waste public Money. You say (Quietly) that you have inherited and retain the old Mental Health Act Commission (MHAC) remit of “safeguarding the interests of detained patients”…..HOW exactly?

    Liked by 1 person

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