Recommendation 86

Training and continued development of directors

A requirement should be imposed on Foundation Trusts to have in place an adequate programme for the training and continued development of directors.

Monitor’s licence conditions require providers to ensure that no person who is an unfit person may become or continue as a director and that they ensure that its contracts of service with its directors contain a provision permitting summary termination in the event 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.

We agree that it is important for directors of all NHS organisations (including foundation trusts) to be provided with the development they need to operate effectively and responsibly.  The recently published The Healthy NHS Board 2013 document sets out a number of measures for the development of individual directors and boards as a whole, including 360 degree feedback, structured induction, peer learning, whole board performance assessment and individual appraisal.  Monitor’s Code of Governance for Foundation Trusts sets out an expectation that directors should also have access, at the NHS foundation trust’s expense, to training courses and/or materials that are consistent with their individual and collective development programme. Monitor’s Quality Governance framework guidance also challenges boards to ensure they have the necessary leadership, skills and knowledge to ensure delivery of the quality agenda. It also suggests boards conduct regular self-assessments to test its skills and capabilities and attend training sessions covering the core elements of quality governance and continuous improvement.

Monitor already has in place programmes provided jointly with others to support chairs, non-executive directors and finance directors. Monitor additionally provides a one-day induction programme for new chairs and chief executives of NHS foundation trusts and is working with the Foundation Trust Network (FTN) to offer a 2-day induction programme for new non-executive directors of NHS Foundation Trusts.  The first of these programmes was run in September 2013 and the next cohort will take place in January 2014.  Monitor will be working together with the NHS Leadership Academy, NHS Trust Development Authority and FTN to increase external support for chief executives of NHS trusts and foundation trusts and will also consider how best to support medical directors in the coming year. The Foundation Trust Network also offers development programmes for executive directors and company secretaries.


Three induction programmes have now been run for Foundation Trust Non-Executive Directors. The first joint Monitor/NHS Trust Development Authority conference for Chief Executive Officers and Chairs was held in October 2014 and is covered strategic planning and transaction guidance.