One in three trusts have at least one vacancy or interim executive on their board, according to a King’s Fund report based on research by HSJ.

Finance director posts have the highest number of vacancies, while nursing director posts have been vacant for the longest period, data released to HSJ under the Freedom of Information Act revealed.

A “perceived blame culture” in which “executives feel exposed if anything goes wrong, even when outside of their control”, may be dissuading people from taking up board roles, analysis by the King’s Fund also found. The think tank’s report pointed to “unrealistic expectations of how quickly change can be achieved”.

It adds that the regulatory burden on trusts meant executives spent “much time satisfying external requirements”. Clinicians faced “specific disincentives” to taking up board positions, the report’s researchers also said.

Joining boards could “deskill their clinical practice” and open gaps in their “skills and experience between clinical and management roles”.
The “limited financial incentives” and “perceived job insecurity” also acted as barriers to board membership, it found.

The report called on national bodies to “[create] a culture and regulatory context that removes the barriers to attracting, recruiting and retaining board level leaders”.

“NHS providers should operate with presumed autonomy with regulators supporting them to innovate, and creating the space for them to do so,” the report recommended.

However, it said the “main responsibility” for maintaining the supply of board members rested with trusts. “There is often a lack of appropriate talent spotting and development support for those aspiring to operate at board levels, contributing to a poor pipeline of candidates for some roles,” the report said.

It said trusts “may… benefit from collaborating with other organisations” but must also develop their own leadership strategies to “ensure an internal pipeline of future leaders”.

One in three trusts have board level vacancies