Recommendation 79

Fit and proper person’s test

Accepted in principle
There should be a requirement that all directors of all bodies registered by the Care Quality Commission as well as Monitor for foundation trusts are, and remain, fit and proper persons for the role. Such a test should include a requirement to comply with a prescribed code of conduct for directors.

We agree that the public have the right to expect that people in leading positions in NHS organisations are fit and proper persons; and that where it is demonstrated that a person is not fit and proper, they should not be able to occupy such a position.  Monitor’s licence conditions for providers of NHS services already prevents licensees from allowing unfit persons to become or continue as governors or directors (or those performing similar or equivalent functions.  They are also required to ensure that their contracts of service with its directors contain a provision permitting summary termination in the vent of a director being or becoming an unfit person.  The licensee is also required to ensure that it enforces that provision promptly upon discovering any director to be an unfit person.

In July 2013, the government issued a consultation on Strengthening corporate accountability in health and social care.   This proposes a new requirement that all board directors (or equivalents) of providers registered with the Care Quality Commission must meet a new fitness test. We are proposing that this test includeschecks about whether the person is of good character including past employment history, if the individual has the qualifications, skills and experience necessary for the work or office, as well as the more traditional consideration of criminal and financial matters.

The government proposes that the fit and proper persons test will now be used as a mechanism for introducing a scheme for barring directors who are unfit from individual posts by the Care Quality Commission at the point of registration.  Where a director is considered by the Care Quality Commission to be unfit it could either refuse registration, in the case of a new provider, or require the removal of the director on inspection, or following notification of a new appointment. Further details will be set out in the response to the consultation on corporate accountability which will be published shortly. We plan to publish the draft regulations for consultation at the same time.

The standards produced by the Professional Standards Authority, Standards for members of NHS boards and Clinical Commissioning Group governing bodies in England, provide the basis for assessing the fitness of senior board-level leaders and managers.


The Department of Health has consulted on a new registration requirement that all directors of providers registered with the Care Quality Commission must meet a fit and proper person test. The Care Quality Commission will be able to insist on the removal of directors that fail this test. The consultation included how the revised fit and proper person requirement will work, and questions about the impact of the new regulations. The consultation ran from 27 March to 25 April 2014. The Fit and Proper Persons Test Regulations have been passed by Parliament and are in place in November 2014 for NHS organisations and from April 2015 for other organisations.