Recommendation 83

Monitor guidance on principles of exercising power

If a ‘fit and proper person test’ is introduced as recommended, Monitor should issue guidance on the principles on which it would exercise its power to require the removal or suspension or disqualification of directors who did not fulfil it, and the procedure it would follow to ensure due process.

Monitor and the Care Quality Commission are committed to ensuring that, taken together, their processes for registration and licensing work effectively to ensure that people in leading positions are fit and proper persons.  The Care Quality Commission will set out in guidance how it will apply the fit and proper persons test as part of its regulatory regime and will ensure that as far as possible its approach in relation to registration is aligned with Monitor’s assessment of fitness as part of its licensing process (which applies to a narrower range of organisations than registration). Monitor has also published guidance on how it will exercise its enforcement powers which are used where there is a breach of licence conditions. This includes procedures for imposing additional licence conditions on NHS foundation trusts and removing, suspending or disqualifying directors or governors of NHS foundation trusts.


The fit and proper person requirement was put in place in November 2014 for directors of NHS Trusts, and in April 2015 for all providers of health and adult social care registered with the Care Quality Commission.

The fit and proper person requirement provides an important mechanism to hold to account individual Directors that have been responsible for the provision of unacceptable standards of care and will assess whether directors:

  • are of good character.
  • have the necessary qualifications, skills and experience.
  • are able to perform the work that they are employed for.
  • can supply information, such as certain checks and a full employment history.