This is the first iteration of the Framework. We will review it after 18 months to assess how effectively it has been embedded and its impact within NHS organisations.

As part of the future review, ‘significant roles’ may also be included within the scope of the Framework and consideration will be given to implementing a public facing register of board members who have been assessed and approved as being fit and proper.

Significant roles are those senior individuals within NHS organisations who have significant influence at the board (or influence over other significant decisions), but are not directors for the purposes of Regulation 5 of the Regulations.

Significant roles added to the Framework are likely as a minimum to include deputy directors, clinical leaders and those involved in key decision-making meetings (this last category will be determined at the discretion of individual NHS organisations).

Furthermore, in future there could be NHS organisations with group structures that have a management board at the parent level, which is supported by subsidiary boards across the various legal entities within the structure. 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.