A system must be devised to make sure that people in senior, board-level, management roles in the NHS have the skills necessary to perform that function.

That is one of the key messages in a review of the Fit and Proper Person Test (FPPT) undertaken by Tom Kark QC.

Mr Kark’s report, which has just been published by the Department of Health and Social Care (DHSC), also calls for those directors to be critically assessed to ensure they have those skills and, where appropriate, supported to improve them.

The report notes that there is little support for the FPPT as it is currently applied, essentially because it does not make sure that directors are fit and proper for the post they hold and fails to prevent those who are unfit or have misbehaved from moving around the system.

Seven recommendations are made for how senior NHS leaders can be better helped to deliver high-quality and safe care in the NHS.

In response, the Government has accepted, in principle, that it will establish a central database of information about the qualifications, previous employment and performance of directors, and that it will make new competency standards to help people know what to expect of senior managers.

The remaining recommendations will, the DHSC explains, be considered as part of the forthcoming workforce implementation plan.

The Kark review points out that there is a “startling lack of information” about the people who manage health Trusts at director level. There is, for example, no centrally-held list of the chief executives or chairs of each of the 229 Trusts in England, or who is on the Board of each.

Neither is any background information kept in relation to Board members, Mr Kark points out, such as where they previously worked and what management experience they have.

The full text of A review of the fit and proper persons test can be found at http://bit.ly/2thkauw.

Last reviewed 11 February 2019