New fit and proper person test framework for NHS boards: new and updated requirements for director level posts introduced

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New fit and proper person test framework for NHS boards: new and updated requirements for director level posts introduced

Published 11 September 2023


Following recommendations from the Kark Review in 2019, the Fit and Proper Person Test (FPPT) has been reviewed and updated by NHS England with the aim of strengthening the individual accountability and transparency of board members. The new FPPT Framework ("the Framework") is effective from 30 September 2023 and needs to be implemented from that date. Chairs will have ultimate responsibility for ensuring their NHS organisation adheres to the Framework. A link to the Framework is here.

The Framework applies to:

  • executive and non-executive directors;
  • all interim and permanent director appointments of over six weeks; and
  • any individuals called "directors" within Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The NHS organisations covered by the Framework are NHS Trusts, NHS Foundation Trusts, ICBs and arm's length bodies including the CQC and NHS England.

  The Framework sets out detailed requirements for:

  • when a full FTTP assessment is required plus annual self-attestation;
  • considerations for new appointments;
  • additional considerations in situations such as joint appointments, shared roles and covering for temporary absences of directors of under six weeks and over six weeks;
  • the role of Chairs in overseeing the FPPT process;
  • the core elements of FPPT to be considered when evaluating board members on an annual basis;
  • what is considered a breach of the core elements of the FPPT;
  • board member reference checks, a standardised board member reference template and the need to retain a reference for a board member even if not requested by a potential employer;
  • maintaining FPPT information on board members in appropriate data fields of the Electronic Staff Record;
  • dispute resolution; and
  • quality assurance over the Framework being conducted by the CQC, NHS England and an external/independent review.

The Framework is not retrospective and it is intended to be implemented going forward. In addition to the Framework a new NHS Leadership Competency Framework is to be published for board level directors in Spring 2024 and will be used for the appraisal and development of board members. The two frameworks are intended to be read together and sit alongside the NHS Constitution, NHS People Plan and the People Promise.


This important Framework is a timely reminder of the core competencies and individual accountabilities of board members. The Framework is aimed at providing a way for directors to provide assurance that the are fit for their roles and also assurance to NHS bodies that unfit directors will not be able to move between them. Employers will need to ensure that the Framework is adopted into their FPPT processes and that all director level appointments are made in line with the new guidance from 30 September 2023 onwards. A reference will need to be completed and retained when any board member leaves post this date.

While Human Resources professionals are not ultimately responsible for this process they will inevitably be involved in assisting with the implementation. They should also ensure that the requirements are brought to the attention of the Chair and the board. The guidance contains useful flowcharts for the assessment, recruitment/referencing process and what happens when a board member leaves. A review will also need to be undertaken of internal policies and contracts to ensure that they are compliant with the Framework going forward.

NHS England Fit and Proper Person Test Framework for board members


Ceri Fuller

Ceri Fuller

London - Walbrook

+44 (0)20 7894 6583

Hilary Larter

Hilary Larter


+44 (0)113 251 4710

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