So You Want To be A Non-Executive In The NHS?

There are many reasons for wanting to become a non-executive in the NHS including wanting to put something back, personal development and getting a foot on the non-executive ladder but whatever the reason, there are some basic things you need to know.

Unless you have been involved in the NHS either as a patient, carer, employee or supplier it may not be apparent that the NHS is not one organisation – In fact there are separate organisations to cover England, Wales, Scotland and Northern Ireland and in England the NHS consists of over 300 autonomous, legally constituted, bodies – each with their own Board of directors – the majority of which are known as Trusts.

When thinking of the NHS you might think of GPs or Hospitals but there are several different types of trust – Acute Trusts (Hospitals), Primary Care Trusts (PCTs), Mental Health Trusts and Ambulance Trusts as well as specialist Trusts such as Learning Disability.

All of these types of trust fall within the remit of the 10 Strategic Health Authorities in England and non-executive director appointments are made by the Appointments commission.

There is another type of Trust – the Foundation Trust – which has more independence than the others and is regulated by an organisation called Monitor. Foundation Trust non-executives are appointed by their own Council of Governors rather than the Appointments Commission.

By the end of 2010 the vast majority of NHS trusts in England will have become Foundation Trusts – many are in the process of applying to Monitor for FT status and this provides an opportunity for potential non-executives as trusts look to strengthen their Boards as part of the application process.

Regardless of their status, there is a strong focus on corporate governance in all the NHS trusts and the Chartered Director qualification is a very good way for potential non-executive directors to demonstrate a personal commitment to the furtherance of good governance.

Whist NHS trusts do not fall within the realms of the Companies Acts their governance is modelled on the combined code – Monitor’s code of governance for Foundation Trusts can be downloaded from the Monitor web-site.

The Appointments Commission makes public appointments for the NHS on behalf of the Secretary of State for Health following the Commissioner for Public Appointments’ Code of Practice to guarantee fairness. All paid appointments are advertised in either the national or local press to give as many people as possible the chance to apply.

The first step in becoming an NHS non-executive is to visit the Appointments Commission web-site ( and search for any vacancies in your area. You can also register to receive e-mail notification of vacancies, either local or national as they arise.

You should also visit the Monitor web-site ( and check their Foundation Trust directory to identify Foundation Trusts in your area. You will then need to visit the web-sites of the individual trusts and check local newspapers for vacancies.

Having identified potential opportunities it is a good idea to visit the web-sites of each NHS trust – there is a wealth of information which will be useful when making your application.

You will be able to see details of the current Board members, both executive and non-executive and you will be able to see where there are possible skills and experience gaps that you could fill.

You will also be able to read previous Board meeting minutes and other papers to get a feel for the issues that each trust is facing.

It is a good idea to contact the Chair of the trust at an early stage for an informal chat as they will have a good idea of the type of person they are looking for.

All NHS foundation trusts have a duty to engage with their local communities and encourage local people to become members of the organisation. NHS foundation trusts have to take steps to ensure that their membership is representative of the communities they serve.

If you are thinking of applying to become a non-executive director of a Foundation Trust then it would be a good idea to join the trust as a member. Anyone who lives in the area, works for the trust, or has been a patient or service user there, can become a member of an NHS foundation trust.

This would give you an opportunity to get involved with the trust and you might also consider standing for election to the Board of Governors.

The appointing body (Appointments Commission or Trust Council of Governors) will be looking for a range of skills and experience from their non-executive members in order to fully reflect the communities they serve.

The Chartered Director qualification will enable you to demonstrate that you have the experience needed to be an NHS chair or non-executive director. In particular they will be looking for experience at senior level in finance governance strategic planning; commercial management; voluntary or community roles and professional areas related to the type of NHS organisation. They should also live in the geographic area served by the trust and its board.

At interview you should be able to demonstrate competencies in commitment to patient needs; forward planning capability; ability to challenge constructively; influencing and persuasion skills; team working approach; self motivation and clear and creative thinking.

As an NHS non-executive director the Appointments Commission anticipate that you will spend around 2.5 days a month in your role – however the reality is you will probably spend at least double that if not more.

You may well be involved in Board committees such as Audit, Remuneration, Finance, Governance or Charitable Funds and there will be strategic away days and Board development session to attend.

If the trust is going through the FT application process then there are likely to be times of intensive involvement with the trust in producing the Integrated Business Plan or preparing for Board to Board sessions with the Strategic Health Authority or Monitor.

If successful your appointment will be for a fixed term of between two and four years, depending on the needs of the organisation.

Remuneration ranges from £6,005 to £12,941 a year, depending on the particular role.

Regardless of your initial motivation, I am sure that you will find life as an NHS NED to be a very rewarding experience where you can make a difference to the lives of patients, service users, carers and employees of the organisation that you serve.

David Doughty

Non-Executive and Vice Chair
Oxfordshire Learning Disability NHS Trust
You can contact David at:

Published by David Doughty

Serial entrepreneur, Software sales and marketing specialist, Chartered Director, Chief Executive, Chair, Non-executive roles in private and public sector, Business consultant and mentor.

6 thoughts on “So You Want To be A Non-Executive In The NHS?

  1. David,

    A very well written and helpful post. I have applied for two NED roles without success so far and have no real idea how close I came to interview. The steer on the Chartered Directors qualification is a valuable one and something for me to look into. I also like the suggestion of talking to the Chair – I wasn’t sure if that breached protocol in some way, but is something for me to bear in mind for the next time.


    1. Neil

      I don’t know if you had the opportunity to visit the trusts where the NED vacancies were when you applied – at the trust where I am a NED we have open-days for prospective NEDs so that they can meet the Board and Senior Managers informally. Many trusts also hold their Board meetings in public – dates and venues are usually published on their web-sites – and this is a good opportunity to see the Board working in practice and to get to know the issue that are being discussed.

      There are usually many more applicants for NED positions than there are vacancies so persistence is certainly required!


  2. Neil

    Can empathise with your comments on applications……….was introduced to the organisation Reach – which is a brokerage between volunteers and various Third Sector Organisation………..including Trustees of Charities etc. Not sure if they cover NHS positions or other Healthcare positions, but you can specify your areas of interest, when you apply.

    Reach service is impressive.

    Happy to share other organisations that I have found to be helpful, if you mail me.


  3. Nice post, David,

    I’ve been a NED at my local acute NHS trust for the last 3 years and it has been a great way to give something back and dip my toe into the world of non-exec’ing. It also helped me think about whether I wanted to reshape my career to once again include more public service (I discovered that I don’t!) and to begin to plan ahead for a possible portfolio career in my later years. I also chair the audit committee and have enjoyed the leadership challenges that the NED role brings.
    The time commitment is as you describe and can be a bugger and the Appointments Commission could do with being a bit more upfront about that.

    Good luck with the blog and I look forward to future posts,



    1. Thanks Nick – it’s always good to hear from other NHS NEDs.

      You might like to join the LinkedIn group for NHS NEDs NEDworks or register to join the discussion group at



  4. David and others who have commented,

    Good practical article and comments. I too have applied for NHS Foundation Trust roles and got as far as the last two! At least the chairman is trying to find ways to get me involved in the hospital.

    In addition to looking at the web sites suggested (and attending a membership meeting) I also found it helpful to read the new NHS Constitution that was developed as part of the NHS Next Stage Review led by Lord Darzi. It can be found on the web site. I also found it helpful to speak to folks who were on the boards of different NHS organisations. Both of these helped me develop my view on the strategic issues involved – it was a question at the interview too!!

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