In recent weeks, I have been contacted by increasing numbers of chairs and non-executives who are struggling with the governance arrangements for the separation of their provider services.
Unfortunately, in the absence of clear guidance from the Department of Health, it has been difficult for the commission to provide advice.
In the main, primary care trusts are establishing provider committees to separate the governance of their provider services. We welcome and support this approach, but feel it raises a number of issues that must be addressed.
Time commitment and remuneration
Establishing provider committees has substantially increased the time commitment of non-executive directors. We advertise non-executive roles as requiring a minimum of 2.5 days per month, but from our online survey we know most non-executives are committing at least double this amount of time. Some have already resigned as a result and we feel this is having a direct impact on our ability to retain high quality non-executive directors.
The issue is exacerbated by the inability of PCTs to remunerate non-executive directors for additional duties. This particularly affects the non-executive chairs of provider committees, who are giving considerable extra time and undertaking additional responsibilities with no reward. The remuneration for non-executive directors is set by the health secretary and there is currently no flexibility for the additional duties of the provider committee chair or any other member to be recognised. In our view, it is vital that this position is addressed and we are calling for provider committee chairs to be remunerated, at a minimum, at the same enhanced level as audit committee chairs.
It is important for PCTs to be aware that independent appointments to provider committees are still public appointments and therefore must comply with the existing remuneration arrangements. We are concerned that some of the ad-hoc arrangements currently being established may be ultra vires and place the PCTs at risk of challenge.
The current arrangements for paying committee members prevent PCTs from compensating people appointed to their committees (apart from paying expenses). This is bound to affect their ability to recruit non-executive committee members of the calibre required to provide effective scrutiny. We are therefore recommending separate arrangements be made for provider committees to enable their members to be compensated for their time, in line with the arrangements that were put in place for other PCT committees.
New appointments to provider committees
We have been approached by a number of PCTs to support them in recruiting additional independent directors to sit on provider committees. We welcome this, but remain concerned that appointments are being made elsewhere without our involvement that may not comply with good practice. Independent appointments to provider committees are public appointments and the authority to make these appointments has been delegated to the Appointments Commission.
One of the models potentially available to PCTs is for the provider committee to apply for community foundation trust status. However, if the committee is not established in line with the Commissioner for Public Appointments' code of practice, the non-executive committee members would all have to go out to open competition in advance of the application, producing further uncertainty.
As I write this, we are awaiting the promised guidance from the Department of Health. We have raised these issues and a number of others with the department on behalf of PCTs and hope we will soon be able to offer you appropriate advice. You can be sure that we will do all we can to support PCTs in their efforts to transform community services.
If you have not yet taken part in our online time commitment survey, you can do so now at www.appointments.org.uk