The national programme to appoint new chairs to all primary care trusts has been criticised as biased, uninformed and hurtful by a number of rejected candidates.

The national programme to appoint new chairs to all primary care trusts has been criticised as biased, uninformed and hurtful by a number of rejected candidates.

An investigation by HSJhas uncovered deep unhappiness at the process run by the NHS Appointments Commission through its subcontractor Human Assets Ltd.

The commission and Human Assets Ltd, which designed and ran assessment centres, reject the allegations.

In a written statement, the commission said the pre-interview assessments, which cost£1,000 per candidate, had been 'very useful' and 'good value'. Allegations of political interference were 'nonsense', it added.

However, this is at odds with the experiences of individuals. PCT chairs who have spoken to HSJ- some on condition of anonymity but others wishing to make their names public - have been highly critical.

Michael Lynch, chair of Huntingdonshire PCT for five-and-a-half years, has resigned in protest at
the way he was treated (see story, right).

Standard rejections
The first criticism is of the way rejections were handled at the early stage of the process, when a panel including new strategic health authority chairs sifted application forms submitted to the Appointments Commission by candidates.

One said: 'I received a standard, unsigned letter saying I had not been shortlisted. There was no explanation and no recognition of the service I have given over four years as chair of the PCT. I found this very hurtful.'

The commission denied that the rejection letter was routinely unsigned or that it was discourteous but added, in a written statement: 'We are sorry if people felt that it was.' It added that all chairs would receive a letter of thanks in due course.

Other chairs criticised the selection criteria, saying their previous experience at PCTs was specifically excluded. HSJhas seen letters from the commission confirming this.

One unsuccessful chair said: 'It seems that it matters more what you do in four hours in an artificial situation in an assessment centre than what you did in four years in the real world.'

However, the commission denied this was true. It said: 'It was clear that previous experience as chairs would be taken into consideration and was indeed welcome.'

Universal criticism
All the chairs who spoke to HSJabout the assessment process were highly critical. One said: 'We were told it was confidential yet I had to sign in when I arrived and there was an open list of people attending. I met colleagues and confirmed more than one person who was rumoured to have applied.'

Others questioned the experience and seniority of the actors and assessors used by Human Assets Ltd. A chair said: 'The role play collapsed when I mentioned the PEC [professional executive committee] and the actress had to stop to say she didn't know what this was.'

Another said there were inaccuracies in the written material.

In his resignation letter to Appointment Commission regional commissioner Rosie Varley, Mr Lynch questioned the experience and background of the assessors.

He wrote: 'In my own case I certainly do not believe that the assessor understood the concepts of &Quot;due diligence&Quot;, &Quot;fiduciary duty&Quot;, &Quot;health needs assessment&Quot;, &Quot;health plans&Quot; or &Quot;local delivery plans&Quot; and other health and business terms.'

In a written statement, Human Assets managing director Charles Woodrough defended the firm's record and performance, saying it was a leader in the design of assessment centres.

He said feedback from 188 candidates showed they had been satisfied that the exercises had given them a fair chance to demonstrate their capabilities. On average, they had judged the exercises 'just right' in their level of difficulty.

He wrote: 'On this basis there is no justification for internal or external candidates to criticise the existence of the process. We should all be reassured that future PCT chairs went through this rigorous process.'

The commission said Human Assets Ltd had been selected through competitive tendering and it was satisfied with the firm's performance.

The final criticism was of the interview panel. Chairs who got this far have expressed reservations about the fact that new SHA chairs were on the panel.

Mr Lynch told HSJ: 'I have been interviewed three times for a PCT chairmanship and never before by the SHA chair. This has given power to the SHAs to appoint people that reflect the SHA rather than the community and I would suggest [this] means that the NHS Appointments Commission is not independent and the process is tainted.'

No political influence
The Appointments Commission said it was standard procedure for SHA chairs to help draw up the shortlist and to sit on interview panels, adding: 'The panel does not make the final decision - they make recommendations to the Appointments Commission.' There had been no political influence over the selection process, it said.

Commission chief executive Dr Roger Moore acknowledged that the process was bound to leave some chairs disappointed. He said: 'It was to ensure that fair judgements were made on the best possible evidence and in accordance with accepted best procedure that the Appointments Commission introduced these rigorous selection procedures involving pre-assessment. The process worked well.'

One successful PCT chair who was not prepared to be named, told HSJ: 'I have some degree of embarrassment at having come through a process successfully where others haven't for reasons that are difficult to fathom.

'I personally was disappointed that the Appointments Commission and their recruitment consultants had only managed to come up with exercises that were so flawed they really should not have been allowed to influence the outcomes.'

Timeline: the appointment process
March 2006: Advert placed in national press seeking applications for chairs of PCTs in England, closing date April 12.

May-June 2006: NHS Appointments aCommission draws up shortlists and invites successful candidates to attend assessments.

June-July 2006: Candidates attend regional assessment centres run by consultancy firm Human Assets Ltd and take part in role-play exercises, written tests and interviews. Written reports sent to regional commissioners.

July-August 2006: Candidates invited for panel interview.

End of July to present: Successful chairs appointed. Unsuccessful candidates informed by letter. All invited to seek feedback on their performance at assessment.