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Directors to be judged on their ability to create ‘compassionate’ cultures

Published on: 3 Aug 2023

NHS England has announced the first details of its ‘Leadership Competency Framework’, and revealed it will be launched this September.

The LCF will underpin the annual appraisal of NHS board directors and, in turn, adherence to the revamped Fit and Proper Person Test.

NHSE also revealed that leaders, including senior clinicians, who hold “significant roles” but are not board members may be subject to the FPPT in the near future.

The new FPPT framework, issued yesterday, said the LCF would contain “six competency domains which should be incorporated into all senior leader job descriptions and recruitment processes”.

The competencies are: “Setting strategy and delivering long term transformation; leading for equality; driving high quality, sustainable outcomes; providing robust governance and assurance; creating a compassionate and inclusive culture; and building trusted relationships with partners and communities.”

The LCF will “form the core of board appraisal frameworks, alongside appraisal of delivery against personal and corporate objectives”, the guidance stated.

The guidance stressed “it is recognised that no board director will be able to demonstrate how they meet all the competencies in the framework. What is sought… is evidence of broad competence across each of the six competency domains, and to ensure there are no areas of significant lack of competence which may not be remedied through a development plan.”

As part of the annual self-attestation process which is part of the new FPPT regime, all board members will have to confirm “whether they have the requisite experience and skills to fulfil minimum standards against the six competency domains”. This “attestation” would then be checked by the director’s line manager, usually the chief executive or chair.

Extending the FPPT

An appendix to the new FPPT framework said it was NHSE’s intention to “review [the FPPT] after 18 months to assess how effectively it has been embedded and its impact within NHS organisations”.

The existing FPPT applies only to NHS board directors, but the appendix stated: “As part of the future review, ‘significant roles’ may also be included within the scope of the framework.”

The appendix explained “significant roles are those senior individuals within NHS organisations who have significant influence at the board or influence over other significant decisions”, but who do not hold board positions.

The appendix suggested the roles likely to fall under the FPPT in the future would, “as a minimum”, include “deputy directors, clinical leaders and those involved in key decision-making meetings”.

It would be up to “the discretion of individual NHS organisations” to decide who should be included in the last category.

Since FPPT was introduced in 2014, the number of trust groups and mergers has grown rapidly, meaning senior figures no longer necessarily sit on statutory boards.

The appendix stated: “In such a scenario, if both the parent and subsidiary boards are responsible for strategic decision-making, it is expected that members across both boards should be subject to the requirements of this framework.”

The appendix also revealed NHSE is considering “a public-facing register of board members who have been assessed and approved as being fit and proper”. However, no further details were given.