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Consultation Document: Local Healthcare Bill



Boards NHSMembership of

1. Members of NHS Boards are appointed to one of 3 categories: non-executive lay members (including the Board Chair); non-executive "stakeholder" members; and executive members. Boards have between 5 and 9 non-executive lay members. The Chair, who is appointed directly by Ministers (not elected by Board members) is always a non-executive lay person. The non-executive stakeholder members comprise:

  • a senior elected Councillor nominated by each of the Local Authorities in whose area the Board provides services;
  • an Employee Director - normally the Chair of the Area Partnership Forum nominated by the relevant NHS staff representative body;
  • the Chair of the Area Clinical Forum - a senior healthcare professional nominated by local clinicians;
  • where the Board is a teaching Health Board (Lothian, Greater Glasgow, Tayside and Grampian are the 4 teaching Boards in Scotland) a University Medical School member - nominated by the local teaching hospital.

2. Executive members are appointed to the NHS Board because of the jobs they do in the Board. Normally the Board Chief Executive, the Director of Public Health, the Director of Finance, the Nurse Director, and the Medical Director are appointed. In some instances the Director of Human Resources is also a member.

Appointments Process

3. All NHS Board members are appointed by Scottish Ministers. They are accountable to Ministers and through them to the Scottish Parliament. Guidance provided to members makes clear that as Board members they are not there to represent a particular body or group; and they must abide by the principles of collective responsibility and bring impartial assessment to bear on the business of the Board.

4. Appointments of non-executive lay members are overseen by the Office of the Commissioner for Public Appointments in Scotland ( OCPAS), through the application of a Code of Practice that is based on 7 principles recommended by the Nolan Committee on Standards in Public Life. The consistent theme running through these principles is a "fair to all" approach. All Chair/non-executive appointments are based on merit, through the application of a rigorous, independent and open assessment in accordance with the OCPAS Code of Practice. Appointments are normally for 4 years.

5. Public appointments to stakeholder positions are made following a nomination process.

6. Public appointments of executive members are made on the basis of the role undertaken by the respective executive Director. Executive appointments remain current as long as the post holder continues in their particular role/area of expertise.

Overall Size of Boards

7. NHS Boards need to be big enough to ensure that there are enough lay members to carry out the important functions required of them. This includes scrutinising and reviewing the activities of the local NHS system, for example by providing chairs and members for important scrutiny committees such as Audit, Clinical Governance and Staff Governance. However it is also desirable for Boards not to be so big that meetings become unmanageable or members feel themselves remote from the business of considering evidence and making decisions. There is currently no upper limit set for the number of Board members and the overall size and balance varies in different areas. NHS Greater Glasgow and Clyde is the largest NHS Board with 32 members. The 3 Island Boards have around 13-15 members each.