Nearly three-quarters of hospital and mental health provider chairs back the introduction of a “fit and proper person test” for membership of trust boards, an HSJ survey has found.
Sixty chairs responded to an HSJ/Odgers Berndtson survey following the publication of Robert Francis’ public inquiry report into failings at Mid Staffordshire Foundation Trust.
The report proposed the introduction of a “fit and proper persons test” for board members, based on a code of conduct. Those who did not pass the test – or breached the code – would not be allowed on boards.
Asked whether they thought this was an “appropriate and effective measure”, 73 per cent of chairs said they did. Twenty-four per cent said they did not, and 3 per cent did not know.
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Ninety-six per cent said they would still be prepared to be a chair if the measure was introduced, with the remainder saying they did not know.
Mr Francis’s recommendation of introducing criminal sanctions for misleading the public or regulators was less popular. He recommended that “wilfully or recklessly false statement of fact” about care quality would be a criminal offence.
Fifty-eight per cent of chairs thought making this a criminal offence would be “an appropriate and effective measure”.
And one in seven respondents said they would no longer be prepared to serve as a chair if the recommendation became law.
Chairs were split almost evenly on the question of whether their board would operate differently in the wake of the Francis report.
Thirty per cent said they would “concentrate more on quality” and 16 per cent intended to shift some of the board’s emphasis from strategic issues to operational issues.
One hospital trust chair said it would “reflect poorly” on a board if it felt it needed to change in response to the report.
He said: “The Francis report covers ground that has been worked over pretty intensively since 2009 and I would be surprised if all, or almost all, NHS organisations had not already fully absorbed the lessons.
“That doesn’t mean that there is any reason for complacency or for thinking that we can’t improve, but it does not reflect well on the inquiry process that we should still have to talk about Mid Staffs in 2013.”
Foundation Trust Network chief executive Chris Hopson, responding to the findings, warned that strengthening law or regulation of boards risked dissuading individuals from serving.
He said: “The survey correctly highlights a key risk the NHS faces going forward – our ability to attract and retain the right calibre of board members.
“Any proposals developed post-Francis need to ensure boards have the right quality of non-executives to function effectively as well as clear and appropriate accountability mechanisms for individual directors.
“I’ve been struck by how successful foundation trusts have been in improving the quality of their non-executive directors…
“But being an NHS trust non-exec is already a difficult and complex task and if the risk/reward balance of doing these roles substantially shifts to increase the risk, for example personal reputational risk, this pipeline [of those interested in the roles] could dry up.”
Trust chairs believe there are other Mid Staffs-type failures
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