Recommendation BRIS-91: Subject healthcare managers to regulatory bodies and professional codes of practice
From Bristol Heart Inquiry — Final Report, published 18 July 2001.
Recommendation
Managers as healthcare professionals should be subject to the same obligations as other healthcare professionals, including being subject to a regulatory body and professional code of practice. (See Recommendation 70.)
Government response
No government response to this recommendation is on the record yet.
Delivery
DHSC and NHS England state no delivery position (27 February 2026)
The new government manifesto includes a commitment to introduce professional standards for NHS managers and bring them into regulation. The department is currently exploring options for taking this work forwards.
The NHS Leadership Competency Framework for Board members (2024) supports the recently refreshed Fit and Proper Persons regime. An independent evaluation is planned for 2025.
NHS England is also developing a management and leadership framework, which will include a Code of Practice for all leaders and managers.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Superseded”. Table row: section 6.2 No. 91, PDF page 112.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
The Government agreed in part with this recommendation.
In its January 2002 response, the Department of Health said it did not think it practicable to establish self-regulation for senior managers. The Department agreed that the standards expected of senior managers should be explicit, and it favoured a code of conduct, stronger performance management and tighter contracts.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 6.2 No. 91, PDF page 101.
Themes and tags
Who has spoken
- DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding