NHS board directors have less than two months to challenge the information that will be gathered on their fitness to hold a leadership position and then stored on their employer’s electronic staff record as part of the overhaul of the fit and proper person test.
The information will be used to inform a “standard reference” when a director leaves and will remain on the relevant ESR until the director’s 75th birthday.
The revised FPPT framework published by NHS England yesterday, comes nearly five years after Tom Kark QC’s review into the regulations, which were delivered to the Department of Health and Social Care in November 2018 and made public early the following year.
The new framework effectively sets out how NHSE will implement the four Kark proposals broadly accepted by the government. They were the creation of: “specified standards of competence” for board directors; a “database of directors”; a “mandatory reference requirement for each director; and the extension of the FPPT to arms-length bodies including NHSE and the Care Quality Commission.
Yesterday’s announcement from NHSE also provided the first details of the new NHS leadership competency framework which will underpin FPPT assessments and suggested the test could be extended beyond board directors to other senior figures, including clinical leaders.
As well as the requirement of the new LCF, directors’ fitness will be assessed under three categories: “good character; possessing the qualifications needed, competence, skills required and experience; and financial soundness.”
How the new FPPT will work
The revised framework says information will be collected on the “fitness” of NHS board members in two phases. The first involves the director’s employer undertaking an FPPT when appointing someone to its board, whether through promotion or a recruitment process.
The second phase involves an annual self-attestation process during which directors will have to confirm they comply with the FPPT.
The NHS ESR is being revised to add new data fields which will capture the information required by the new FPPT guidance. This data would be accessible only to the organisation’s chair, chief executive, chief people officer, company secretary and a senior independent director.
Information held on the ESR will include employment history, references from previous employers or other board members, upheld disciplinary findings that include misconduct or mismanagement, and any ongoing or discontinued investigations relating to disciplinary, grievance, whistleblowing or employee behaviour.
The ESR records will be used to populate a standard reference which would be produced whenever a board director leaves their role.
The guidance says the standard reference will “help foster a culture of meritocracy, ensuring that only board members who are fit and proper are appointed to their role, and that there is no recycling of unfit individuals within the NHS.”
It adds: “The chair will write and sign off all NED references, the CEO will write and sign off all ED references.” It adds: “Where possible, the person would have had sight of the reference and know what had been included.”
Challenging the record
NHSE chair Richard Meddings said: “NHS chairs will be responsible for ensuring the new fit and proper person test is implemented at their organisations, so that we can improve patient safety across the health service, and prevent directors who have been involved in misconduct or mismanagement from moving from one NHS organisation to another, without prospective employers having a full and more detailed background check.”
Guidance specifically produced for chairs states: “NHS organisations, as data controllers, must communicate to all directors whose details will be included in ESR and local records from October 2023 onwards. By doing this, directors will be afforded the opportunity to object if they have concerns regarding the proposed use of their data.
“It is suggested that directors are advised of the areas that will be considered under the FPPT assessment, what details will be stored and where, who will have access and the purpose.”
A letter to integrated care board and trust chief executives about the new framework from NHSE chief executive Amanda Pritchard said: “We are aware that this framework introduces new and more comprehensive requirements around board appointments and annual review, which organisations will need time to implement.”
From 30 September 2023, NHS organisations must use “the new board member reference template for references for all new board appointments”, as well as using “the Leadership Competency Framework as part of the assessment process when recruiting to all board roles”.
The guidance states all NHS organisations must “fully implement the FPPT framework incorporating the LCF, including updating the ESR database” by 31 March next year.
Questions over value
Caroline Waterfield, NHS Employers’ director of development and employment, said the framework “goes further than the current test” in terms of what it asks employers to do”.
She added that the “gap” created by the FPPT’s failure to cover NHSE and CQC had “now been closed”.
Miriam Deakin, NHS Providers’ director of policy and strategy, said she was pleased to see the framing of the FPPT within a “broader programme of board development”, but warned “questions remain” about how it will add value to existing practice.