FPPR or Flimsy Pointless Pusillanimous Reaction. Cornwall Partnership NHS Foundation Trust: CQC looks foolish again

By Dr Minh Alexander retired consultant psychiatrist 7 May 2022

On 28 January 2014 an Employment Tribunal ruled that South Devon Healthcare NHS Foundation Trust had harmed two whistleblowers, Penny Gates and Clare Sardari, who had raised concerns about nepotism by the trust’s then CEO, the infamous Paula Vasco-Knight.

The Employment Tribunal concluded that Vasco-Knight had breached the NHS managers’ code of conduct.

The regulator Monitor later helped to recycle Vasco-Knight as an NHS director to a locum post at St Georges.

The Care Quality Commission was asked to review Vasco-Knight’s fitness under CQC Regulation 5 Fit and Proper Persons (FPPR). It did so cursorily and Mike Richards the then Chief Inspector of Hospitals personally shut down the FPPR:

CQC: A Chief Inspector DOESN’T call

Mike Richards  

After retiring from the Care Quality Commission in 2017 Mike Richards got a nice job at PwC in the same year

He was also appointed as a non executive director to the Department of Health and Social Care board

Richards also joined the private organisation Incisive Health as “senior counsel”

He was recently announced as the new UK National Screening Committee chair    

The CQC’s actions allowed Vasco-Knight’s promotion to the post of interim CEO at St. Georges, completing her rehabilitation despite the whistleblower reprisal and nepotism.

The CQC was severely embarrassed when shortly after this, Vasco-Knight was charged with and eventually convicted of a criminal fraud against the NHS from her tenure as CEO at South Devon.

The CQC never took any responsibility for this FPPR botch, despite a subsequent PHSO finding against it in this matter. It issued a non-apology to Clare Sardari but then undermined even this with its further public statements excusing itself:

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

NHS England and NHS Improvement who had also been complicit in building up the Vasco-Knight brand also evaded taking proper responsibility for their part in these matters.

Postscripts on Paula. NHS England’s apologia & regulatory reticence

Vasco-Knight was not the only director of South Devon Healthcare NHS Foundation who was criticised by the Employment Tribunal that found whistleblower reprisal.

The trust chair Peter Hildrew was criticised for an extraordinary cover up of Vasco-Knight’s misconduct.

The trust Human Resources Director Adrienne Murphy was also found guilty of whistleblower reprisal, for trying to dissuade Gates and Sardari from pursuing their concerns and making them feel intimidated. Not only did Murphy make the whistleblowers feel intimidated, but according to the ET, Murphy tried to convince the trust Chair not to investigate the whistleblowers’ concerns about her behaviour and that of Paula Vasco-Knight. The ET also determined that the trust’s procedural response to the whistleblowers had been unfair. The HR director’s role in this must be in question.

Parallel to the FPPR process on Vasco-Knight, another FPPR referral was made to the CQC on Adrienne Murphy. She had been given a job as HR director by the mental health trust Cornwall Partnership NHS Foundation Trust, despite (or perhaps it was even because of?) the history of ET proven whistleblower reprisal.

Biog taken from Cornwall Partnership NHS Foundation Trust website

The usual CQC prestidigitation resulted in a declaration in November 2016 that all was well and that the trust was compliant with FPPR.

Fast forward to 2021 and a significant scandal emerged of four trust directors at Cornwall Partnership NHS Foundation Trust being overpaid, reports of an ongoing NHS Counterfraud investigation and resignation of long served trust CEO Phil Confue.

The press reported Phil Confue was believed to be one of the executives who received an over payment. The reports of a NHS Counter Fraud Authority investigation into the trust have neither been confirmed nor denied by the trust.

Phil Confue’s company

According to Companies House, Phil Confue was a director of a company, with the former medical director of Cornwall Partnership NHS Foundation Trust 2000-2019, who is now the Chief Clinical Information Officer of the trust:  

PSYCHOANALYTICA COMMUNITY INTEREST COMPANY  

Companies House records indicate that Confue resigned his directorship of this company on 22 June 2021.
The former medical director of Cornwall Partnership NHS Foundation Trust 2000-2019

There is woefully little information about the executive overpayments in the public domain. We know that the four directors had to repay the monies, but despite their seniority and the legitimate public interest, we do not know with any certainty who they are.

Normally such arrangements are made with advice from the most senior Human Resource officer. What senior HR advice, if any, contributed to this ill-advised overpayment?

I asked the trust for more information about investigations in recent years and about the executive overpayments.

This is the trust’s FOI response:

Cornwall Partnership NHS Foundation Trust FOI response executive over payments and investigations  6 May 2022 Ref 89587

The trust indicated that there had been a flurry of activity:

“There have been eleven external reviews/ investigations commissioned by the trust in the last three years.”

“The issues covered relate to the following areas:

  • Governance
    • Trust culture
    • Human resources matters
    • Matters raised through Freedom to Speak Up”

“Four are in progress and seven have been completed. Information relating to the findings of the cultural review, carried out as part of the trust’s undertakings, have been shared in a number of forums, internally and externally and with staff.

Of the reviews/investigations that have been completed, none have been published. The nature of reviews/investigations are such that details would not be appropriate for publication, even in a heavily redacted form, and would be covered by several exemptions to the right of access under the Freedom of Information Act 2000.”

This is unwarranted secrecy by the trust, especially as the broad outcome of one of these reviews is in the public domain. The March 2022 trust board papers revealed an audit of trust complaints was undertaken by Audit South West. The audit found gross failings in trust governance underlying a huge backlog, such as lack of staff training to handle complaints, lack of complaints tracking, lack of proper investigation and breaches of regulations. The matter was reported in the Health Service Journal recently:

Governance scandal trust failing to manage complaints

Moreover, minutes of a trust board meeting in December 2021 refer to actions arising from the cultural review mentioned in the trust’s FOI response, albeit I could not find the report itself amongst published trust papers:

HR, workforce, and organisational development

Adrienne Murphy said that there was a backlog in the agenda for change job matching process and this was being prioritised. The winter offer for staff health and wellbeing was being revisited and the HR team was meeting with the leadership academy to take on the actions from the cultural review. It was also noted that a business case was being written for substantive resources to be allocated to inclusion and diversity work”

Regarding the executive overpayments, the trust made these comments in its FOI response:

“A single flat rate of payment was made to four members of the board.”

“All four payments have been repaid.”

“This information is exempt from release by virtue of Section 40 (2) of the Freedom of Information Act 2000.”

So it seems implicitly from all the above that Human Resources, including whistleblowing governance, is not a roaring success at the trust.

Who could have predicted that? Not the CQC anyway.

Cornwall Partnership NHS Foundation Trust is currently rated ‘Good’ by the CQC despite being an obvious governance mess:

CQC made many nice comments about the trust board, such as:

“The culture of the trust had improved with high morale in the majority of services. Staff felt respected, supported and valued by their managers and the trust.”

“The board and senior leadership team had set a clear vision and values that were at the heart of all the work within the organisation.”

The effusive CQC inspection report authors were:

“Karen Bennett-Wilson chaired this inspection and Gary Risdale led it. An executive reviewer, Jan Bergman, supported our inspection of well-led for the trust overall.”

Jan Bergman was formerly an NHS trust CEO and has also worked as Director of Transformation and Deputy CEO at the Rotherham NHS Foundation Trust.

As a local Tory councillor for Weymouth Bergman’s current declaration of interests  states that he is a “Transformation Consultant, NHS (3days/week)” as well as a CQC specialist adviser.

Despite the trust’s flashing neon “Keep Out” signs, I will ask Cornwall Partnership for more information about the extraordinary number of external reviews and investigations of the trust’s governance in the last three years, and the process by which the four directors came to be over paid. I will also challenge the decision to withhold their names on the basis of their seniority and the very legitimate public interest in the governance of an organisation responsible for so many vulnerable patients.

PETITION

Please click and add your signature to this petition to reform UK whistleblowing law – whistleblowers protect us all but weak UK law leaves them wholly exposed, lets abusers off the hook and it is a threat to public safety.

Replace weak UK whistleblowing law and protect whistleblowers and the public

RELATED ITEMS

Dr Jasna Macanovic’s recent NHS whistleblowing case adds to the pile of managerial recycling scandals. John Knighton the medical director found by the ET to be centrally involved in her premeditated unfair dismissal has been protected by the trust and Mark Cubbon the trust CEO who failed to ensure her protection as a whistleblower has been promoted to a senior post at NHS England.

Portsmouth Hospitals University NHS Trust sacked Dr Jasna Macanovic consultant nephrologist for whistleblowing to the General Medical Council

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

These are other posts on the same theme:

Sir Robert’s Flip Flops

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

Post Office Horizon scandal: How Dido Harding helped to recycle Paula Vennells, FPPR and a suggestion for the BEIS Minister

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

Steve Trenchard, NHS regulators & FPPR

FPPR: CQC has lost all moral authority, but what will the National Guardian do?

Postscripts on Paula. NHS England’s apologia & regulatory reticence

National Guardian ‘Expects’

One thought on “FPPR or Flimsy Pointless Pusillanimous Reaction. Cornwall Partnership NHS Foundation Trust: CQC looks foolish again

  1. As per normal, I have little constructive to say other than to thank you.
    Nevertheless, having read this woeful and all too familiar record of events, I do ponder. Would it be possible to audit the effectiveness of the actual work that these bureaucratic characters contribute with respect to patients’ outcomes?
    I have this terrible feeling that if they were all to retreat from the workplace for a while, there would either be no difference to patients’ wellbeing or their welfare might even be allowed to improve.

    Like

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