Why the NHS's 'fit and proper person test' should be an industry standard

The framework for vetting executive and non-executive directors could benefit more than just the NHS. -

On 30 September the NHS rolled out its 'fit and proper person test' (FPPT) framework for vetting top-level executive and non-executive directors.

The move is designed to strengthen board governance, boost leadership and improve patient safety and, as such, should be welcomed.

But the NHS isn't the only industry in dire need of such checks.

While it is easy to scrutinise rank-and-file employees, senior leadership positions often go under-vetted and this can have disastrous consequences.


Could better HR save the NHS?


The introduction of the FPPT framework comes on the back of a 2019 review by Tom Kark which sets out seven recommendations to ensure that both interim and permanent directors in the NHS, independent healthcare and the adult social care sector are ‘fit and proper’ to be in their roles.

In the new framework senior leaders in the NHS will be subject to enhanced vetting including six years of references and social media checks.

With global social media use predicted to hit 4.9 billion by the end of 2023, it’s becoming an indispensable tool for gauging character, providing a more unfiltered look into a person's character than a well-rehearsed interview could ever offer.

This approach ensures that those making high-impact decisions not only have the right qualifications but that there are no skeletons in the cupboard.

It's a rigorous screening process which would make it difficult for senior leaders who have been involved in misconduct to simply jump ship to another NHS division.


NHS urged to embrace ‘systems leadership’


In his review Kark noted that the “quality of management within the NHS is an issue of considerable national importance.

The behaviour and ethos of staff within our hospitals are often heavily influenced by the behaviour and ethos of the directors on the Trust Board and especially those of the chief executive and the chair".

He added: "Good hospitals run well because they have good, focused leadership and well-trained and enthused staff who are enabled to focus on providing good, safe and compassionate care for their patients.”

But it’s not just in healthcare that the behaviour and ethos of directors influences all employees. Poor leadership can cripple organisations, whether they be tech startups or financial services firms.

Senior members are often treated as untouchable demigods, too important to be subject to the same checks that everyone else must pass.

This creates a dangerous loophole, where individuals with questionable pasts can attain positions of power.

Despite the urgent need for thorough vetting, especially given the increasingly politicised and litigious landscape we operate in, many industries are dragging their feet.

Financial services have something resembling a 'fit and proper' test but that's not enough.

Today’s top-tier decisions can become tomorrow's headlines and reputational risks are just a social media post away. Thousands of jobs rely on the decisions made by these individuals.


Rethinking EDI in the NHS


So why aren’t more sectors proactively safeguarding their interests?

Often, there's a kind of fear factor at play when it comes to scrutinising top-level executives. Boards and HR directors fear alienating or offending them, given their clout and connections.

It’s like a white-glove service where these senior executives are trusted on their word rather than having to fill in online forms like everyone else. 

Lax vetting of top-tier executives can have a catastrophic impact on a business. So it's time to broaden the remit of what constitutes a 'fit and proper person’ to encompass more than just the healthcare sector. The NHS framework is a timely reminder that no one, irrespective of their position, should be above scrutiny. Comprehensive vetting should be an industry standard, not the exception.

Susie Thomson is managing director at Matrix Security Watchdog