National clinical directors and other likely candidates are being excluded from applying to key posts in the NHS Commissioning Board.

The board is in the process of appointing a deputy medical director covering primary care and a director for each of the five domains of the NHS outcomes framework.

They are expected to be important jobs in the new commissioning system and appear to differ significantly from existing roles. HSJ understands the board has been unable to recruit to some of the posts, but they are still currently only open to a pool of staff whose jobs will be abolished in April next year.

These include senior Department of Health civil servants, and directors and deputy directors from strategic health authorities, primary care trusts and arm’s-length bodies.

HSJ understands the majority of national clinical directors – whom are generally employed on fixed-term, part-time contracts and on secondment to the DH – are excluded. Some would otherwise be considered strong candidates, according to a senior NHS source.

 Hospital clinicians would be strong candidates for several posts, for example the domain director for “recovering from illness or injury”, related to urgent and emergency care, which is yet to be filled. But those working for NHS provider trusts are also excluded under the rules.

HSJ’s source said some of the best candidates were being excluded by an agreement with unions not to recruit from outside the pools.