Recommendations from the Kark review

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The Kark review, led by Tom Kark QC, has reported back on the effectiveness of the fit and proper persons tests for senior NHS staff.

The independent review sets out seven recommendations. We await further details as to their implementation and for now fit and proper persons tests should be applied as per previous guidance.

The recommendations from the review are as follows.

  • All directors (executive, non-executive and interim) should meet specified standards of competence to sit on the board of any health providing organisation. Where necessary, training should be available.
  • A central database of directors should be created holding relevant information about qualifications and history.
  • A mandatory reference requirement for each director should be implemented. This would mean there could not be omissions of information in a reference, even where a settlement agreement is in place.
  • The fit and proper persons test should be extended to all commissioners and other appropriate arms-length bodies (including NHS Improvement and NHS England).
  • There should be the ability to disbar directors from further roles where they have engaged in serious misconduct.
  • The term 'privy to' should be removed from the regulations. This is in the context of ensuring that board members have not been responsible, involved or ‘privy to’ any serious misconduct or mismanagement. The review suggests ‘privy to’ is unclear and undefined.
  • Further work should be done to examine how the test works in the context of the provision of social care and whether any amendments are needed to make the test effective.

The recommendations are due to be considered as part of the wider workforce review being led by NHS Improvement. 

Read more about each of these recommendations in full, in the Kark review report.

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