Clinicians have not been appointed as non-executive directors on the NHS Commissioning Board in order to avoid undermining the chief nurse and medical director, chair Malcolm Grant has said.

HSJ understands the board had previously been planning to appoint a doctor to a non-executive position.

But speaking at a session at the NHS Confederation conference last week, Professor Grant said: “We didn’t put clinicians on [the board as non-execs] so as not to undermine the clinical leadership of [medical director Sir] Bruce Keogh and [chief nurse] Jane Cummings.”

The appointment of four additional non-executives to the board was announced last week. They are Lord Victor Adebowale, chief executive of the charity Turning Point and crossbench peer; Margaret Casely-Hayford, director of legal services and company secretary, John Lewis Partnership PLC; Dame Moira Gibb, a civil service commissioner and former chief executive of the London Borough of Camden; and Naguib Kheraj, vice chairman of Barclays Bank PLC.

Professor Grant was asked about the commissioning board’s plans to establish new clinical networks and senates. He said the board did not intend to do anything to “disturb” existing networks.

He said clinical senates around the country would provide advice to clinical commissioning groups and others, ensuring the system was clinically led. Asked who was in charge in the reformed NHS, Professor Grant said the new system was a “distributed model”.

He said its main office in Leeds was not a headquarters but a “national support office”. However, he warned it would be “impossible” for health secretary Andrew Lansley to step back from an extensive role in the health service, “unless autonomous bodies demonstrate capacity for leadership”.