The Flexible CQC, FPPR & Kettering General Hospital NHS Foundation Trust

By Dr Minh Alexander, NHS whistleblower and former consultant psychiatrist, 16 January 2018 

The CQC has thoroughly disgraced itself in failing to hold unfit NHS trust directors to account despite being assigned powers in 2014, under Regulation 5 Fit and Proper Persons (FPPR).

CQC’s senior staff have been involved in turning a blind eye to wrongdoing such as whistleblower reprisal and suppression of patient safety issues. CQC’s former Chief Inspector of Hospitals personally shut down an FPPR referral on the hospital boss Paula Vasco-Knight who was shortly after charged with fraud, and eventually convicted.

In May 2017 last year a scandal erupted when the BBC reported allegations of a waiting list fiddle at Kettering General Hospital NHS Foundation Trust, based on information provided by a whistleblower, who had started raising concerns internally in 2015.

Kettering General Hospital ‘fiddled’ waiting time records

By Matt Precey BBC East

26 May 2017

Screen Shot 2018-01-15 at 08.53.23

The trust denied wrong doing but by July 2017, both the trust CEO and Chair resigned:

Prior to the BBC coverage of the waiting list allegations, the CQC had rated the trust ‘Inadequate’ in April 2017 and placed it into special measures:

CQC inspection report Kettering April 2017 AAAF9991

Kettering was rated ‘Inadequate’ again in September 2017:

CQC inspection report Kettering September 2017 AAAG6609

Mike Richards the former CQC Chief Inspector of Hospitals wrote the introductory letter for the CQC inspection report on Kettering of April 2017.

Whilst Richards noted that the CQC had judged the trust to be ‘Inadequate’ on the ‘Well-Led’ domain and required Special Measures, he made no comment on Regulation 5 issues or whether trust directors were Fit and Proper Persons.

Neither was the trust’s compliance with FPPR discussed anywhere else in the CQC’s April 2017 report.

Curiously, there were almost no comment in general about the senior leadership of the trust in the report, with most comments in CQC’s report being directed only at the leadership of individual service areas.

The CQC inspection report informed the public that the trust had been served with a formal Section 29A warning notice, but few details were given:

Screen Shot 2018-01-16 at 17.21.11

I later asked the trust for a copy of CQC’s Section 29A warning notice. It proved to be lengthy and detailed:

CQC FOI REF 4060 s29A Warning Notice Kettering General Hospital NHS Foundation Trust.

Of interest, the CQC’s Section 29A letter to Kettering of 18 November 2016 revealed that the CQC had been concerned about weak FPPR procedures at the trust:

Screen Shot 2018-01-16 at 19.19.31

Inexplicably, none of this troubling information appeared in CQC’s subsequent inspection report in April 2017.

It is both interesting and of concern that CQC withheld this information from the public, in addition to the paucity of comment in its inspection report about the trust’s senior leadership.

The more so given CQC’s now long track record of protecting erring and failing trust directors.

It has to be asked what else the CQC has been hiding from the public, and why.

Such economy with the truth may not be unconnected to the fact that trust directors are themselves expected to support political pantomimes and not to make too much fuss about undeliverable policies.

Such a house of cards would fall if folks who know where the bodies are buried are pushed too far.

This example at Kettering also illustrates another typical aspect to CQC’s behaviour. Whether by action or omission, it helps to shield senior managers involved in whistleblowing cases, and is thus an essential cog in the Department of Health’s reputation management machine.


PHSO has partially upheld a complaint about CQC’s mishandling of an FPPR referral about former NHS trust chief executive Paula Vasco-Knight and made a finding of maladministration and systemic failure. Alas, the graceless CQC remains defiant and keeps spinning itself deeper into a hole:

Sorry is the hardest word: CQC, Paula Vasco-Knight and Regulation 5 Fit and Proper Persons

DH Shooting messenger


This is disclosed FOI material from CQC which includes guidance to inspection teams and a withering internal audit:

Disclosed: CQC’s internal technical guidance on Regulation 5 Fit and Proper Persons and an internal audit on CQC’s woeful handling of FPPR

Post-scripts on Paula, NHS England’s apologia and regulatory reticence

Letter to Public Accounts Committee 11 September 2017 requesting a review of whistleblowing

One thought on “The Flexible CQC, FPPR & Kettering General Hospital NHS Foundation Trust

  1. Your evidence is invaluable.
    Thank you.
    Unfortunately, such is the decline in so many areas of ‘medicine,’ evidence is held in little regard.
    Please accept my kind regards,

    Liked by 1 person

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