NHS Leadership Competency Framework for Board Members

Scrutiny and criticism of NHS directors / boards arising from various high profile NHS scandals and incidents in recent years provided the impetus for heightened governance and monitoring of their performance, with a view to also establishing consistent standards across the NHS.

Following the introduction of the Fit and Proper Persons Framework last September, NHSE’s latest development in this area, the NHS Leadership Competency Framework for Board Members (the Leadership Competency Framework) was published on 28 February 2024. Its sister Board Member Appraisal Framework (the Appraisal Framework), which will include guidance on assessing directors’ performance against the six domains in the Leadership Competency Framework, is expected this autumn.

What is the Leadership Competency Framework?

The Leadership Competency Framework, resulting from a collaboration including NHS Providers, NHS Employers and the NHS Confederation, was developed following the recommendation of Tom Kark KC’s review of the Fit and Proper Persons test in 2019. It is said to align to Our NHS People Promise, Our Leadership Way and the Seven Principles of Public Life (the Nolan Principles) as well as the NHS Values.

Purpose / aims of the Leadership Competency Framework

The framework, which applies to all board members, assesses them as part of a unitary board and is designed to:

• support the appointment of diverse, skilled and proficient leaders
• support the delivery of high-quality, equitable care and the best outcomes for patients, service users, communities and our workforce
• help organisations to develop and appraise all board members
• support individual board members to self-assess against the six competency domains and identify development needs.

It is intended to be a ‘cradle to grave’ tool for trusts in the employment of executive directors and the engagement of non-executive directors. It is applicable from before their appointment, by virtue of it being referenced in job descriptions and recruitment processes, as an evaluation and developmental tool in appraisals throughout a director’s tenure, and even in the provision of references for departing directors.

What does the Leadership Competency Framework say / do?

The Leadership Competency Framework is split into six competency domains, which cover key leadership issues involving service delivery, strategy, governance and workforce leadership issues. It espouses that “the six domains identify competency areas and provide examples of leadership practice and behaviours which will support delivery against” [directors’ own] “more detailed individual, team and organisational objectives”. The domains are:

1. Driving high quality and sustainable outcomes
2. Setting strategy and delivering long term transformation
3. Promoting equality and inclusion, and reducing health and workforce inequalities
4. Providing robust governance and assurance
5. Creating a compassionate, just and positive culture
6. Building trusted relationships with partners and communities

Each domain is further split down into specific competency statements under the sub-headings of:  

“I contribute as a leader to…”; “I assess and understand…”; “I recognise and champion the importance of…”; “I personally…..”

A key tenet of the Leadership Competency Framework is professional development.  It is recognised that few, if any, board members will be the full ‘polished article’ but will be working to make progress generally in various areas of their leadership, but especially where it is identified that particular improvements are needed. There is cross reference to the Directory of Board Level Learning and Development Opportunities page of the NHSE Fit and Proper Persons Test Framework, which was published last August (01 August 2023) to signpost directors and their trusts to available developmental tools, courses, programmes etc.

What action is required?

Trusts need to incorporate the domains into their job descriptions and appraisal processes. An optional scoring guide for individuals to self-assess themselves is included in the Leadership Competency Framework at Appendix 2, which provides “ratings” boxes for each of the competency statements within the six domains. The ratings are:  Almost always; Frequently; Occasionally; Rarely or never; No chance to demonstrate.

We expect many trusts will adapt and adopt as a starting point, pending the Appraisal Framework being published later in the year. If doing so, we suggest considering including additional space or another column to allow further written explanation / comments to be recorded, where appropriate, to support the overall rating box which has been selected.  

Equality and culture are significant aspects and, from the outset the framework sets out its stall in terms of identifying board members as responsible for the culture of an NHS organisation and that the framework is designed to ensure their responsibilities in that area are clear and will be assessed.

Comment

As well as a general assessment tool, the Leadership Competency Framework is an addition to the management and governance toolkit available to NHS trusts in the drive to identify concerning weaknesses or failings of board members and address them, rather than leaving them in the “too tricky” folder or allowing the problem to move on to another part of the NHS.

Dealing with competency concerns can often be a challenging process, especially when the individuals concerned are senior / board level. Our practitioners are experienced in working alongside NHS trusts, supporting them to achieve a positive outcome and have confidence that the procedural complexities are managed to minimise the inherent litigation risks. View the Leadership Competency Framework here.