Scrapping the legal guarantee that a nurse sits on every foundation trust board is a “brazen attack on patient safety”, the Royal College of Nursing has warned.

The Health Bill, published this month, would remove the requirement in primary legislation for foundation trust boards to include a registered nurse or midwife and a registered medical practitioner or dentist among their executive directors. Under a new schedule to the NHS Act 2006, the only board roles guaranteed in law would be the chief executive, finance director and chair.

The reason for the change is not given in the bill’s explanatory notes, which describe the new board composition without acknowledging that the clinical requirement has gone. It is also absent from the government’s fact sheet on the legal changes affecting providers, and from its impact assessment on foundation trust reform.

The Department of Health and Social Care, which did not respond to requests for clarification before publication, has since contacted HSJ to say that it plans to recreate the requirement for clinical members in secondary legislation.

Royal College of Nursing general secretary and chief executive Nicola Ranger told HSJ that removing the legal requirement – which has been in place since the creation of FTs in the early 2000s – would “allow for hospitals to make decisions about services for entire populations with no clinical oversight whatsoever”.

More about the National Health Service Act 2006
An Act to consolidate certain enactments relating to the health service

BE IT Enacted by the Queen’s most Excellent Majesty, and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows ‐

PROMOTION AND PROVISION OF THE HEALTH SERVICE IN ENGLAND

♤ Secretary of State’s duty to promote comprehensive health service
♤ Duty as to improvement in quality of services
♤ Duty as to the NHS Constitution
♤ Duty as to reducing inequalities
♤ Duty as to promoting autonomy
♤ Duty as to research
♤ Duty as to education and training
♤ Secretary of State’s duty as to reporting on and reviewing treatment of providers
♤ Secretary of State’s duty to report on workforce systems
♤ NHS England and its general functions
♤ General functions of integrated care boards
♤ General Power
~The Secretary of State may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge from any function conferred on the Secretary of State by this Act.
~NHS England or an integrated care board may do anything which is calculated to facilitate, or is conducive or incidental to, the discharge of any of its functions.
♤ Secretary of State’s duty as to protection of public health
♤ Functions of local authorities and Secretary of State as to improvement of public health
♤ Duty of integrated care boards as to commissioning certain health services
♤ Power of integrated care boards to commission certain health services
♤ Secretary of State’s power to require NHS England to commission services
♤ High security psychiatric services
♤ Performance of functions outside England
♤ Reimbursement of cost of services provided in another EEA state
♤ Regulations relating EU obligations

Sources
https://www.hsj.co.uk/workforce/health-bill-proposal-an-attack-on-patient-safety/7041799.article?mkt_tok=NTI1LVNIQS0zNTUAAAGiITMKe7DZMO8To4VknLf5MMcWxLbRqsVCAvJfkXrzdTJCfpjRjzF6-fFCbBh_72F5TGmTWJyZMXw2qtRAI4rGqbnwdUD_xjmmDbwFyLUEsA
https://www.legislation.gov.uk/ukpga/2006/41

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