New standards for NHS board members

About the Kark Review

In 2014, the Government introduced a requirement, via Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (the 2014 Regulations), on all health and adult social care providers registered with the Care Quality Commission (CQC). This was to ensure board directors, board members and individuals who perform the functions equivalent to the functions of a board director and member, were ‘fit and proper’ for their roles.

In July 2018, the then Minister of State for Health, Stephen Barclay MP, commissioned Tom Kark KC to write a report and to make recommendations in relation to the Fit and Proper Person Test (FPPT) as it applied under Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Tom Kark KC review of the fit and proper person test (the Kark review) was published in February 2019 and made seven recommendations on how to improve the operation and effectiveness of Regulation 5.

In August 2019, NHS England and NHS Improvement (now NHS England) established a Kark Reference Group with a broad membership including appropriate representation from whistleblowers, patients, and a wider range of professional representative groups for managers. The Kark Reference Group was consulted on the Tom Kark KC recommendations, resulting in a set of proposals to the then Minister of State for Health for approval.

The Fit and Proper Person Test Framework

NHS England has published the Fit and Proper Person Test (“FPPT”) Framework, in response to the recommendations made by Tom Kark KC in his 2019 Review of the FPPT.

The Framework is designed to assess the appropriateness of an individual to discharge their duties effectively in their capacity as a board member. It has been designed to be fair and proportionate and has been developed with the intention to avoid unnecessary bureaucratic burden on NHS organisations. However, ensuring high standards of leadership in the NHS is crucial and the Framework will help board members build a portfolio to support and provide assurance that they are fit and proper, while demonstrably unfit board members will be prevented from moving between NHS organisations.

The FPPT applies to executive and non-executive directors of integrated care boards, NHS trusts and foundation trusts, NHS England and Care Quality Commission – interim as well as permanent appointments.

As part of this work, we have published the first suite of board level learning and development offers for executive and non-executive board directors.