An investigation into the NHS's so-called "revolving door" reveals how senior executives disciplined or dismissed for misconduct have repeatedly been re-employed in other well-paid leadership roles across the health service. The case of Paula Vasco-Knight, former chief executive of Torbay and South Devon NHS Foundation Trust, illustrates the problem: after resigning amid a nepotism and bullying scandal, she was appointed to further senior positions before later being convicted of fraud. Critics argue this pattern undermines accountability and puts patients and staff at risk, and successive governments have pledged to end it, though a promised legal fix remains years away.

Vasco-Knight was found to have appointed her daughter's boyfriend to a management role without fair process, leading to a tribunal awarding a whistleblowing nurse £230,000. Despite resigning, she went on to become chief operating officer and then acting chief executive at St George's University Hospitals NHS Foundation Trust, before being convicted of fraud for funnelling £11,072 in NHS funds to her husband's business, receiving a 16-month suspended sentence and losing her CBE. Another case cited is Dr George Thomson, suspended from Rotherham NHS Foundation Trust over "unprofessional behaviour" allegations, who subsequently took up a comparable post elsewhere. The Care Quality Commission's Fit and Proper Person Regulations, meant to screen unsuitable directors, have been criticised as inadequately enforced.