In recent years, the practice of individuals chairing the board of more than one trust has become more common alongside a general trend towards provider consolidation in different forms. There are a number of reasons that the number of chairs overseeing more than one trust has increased. It has long been the practice of Monitor and latterly NHS England and Improvement to ask chairs of successful foundation trusts to take on a dual role as chair of a struggling organisation to help the board of that organisation to improve its governance, and through that, organisational performance. Typically, these appointments have been for a relatively short period and have therefore involved minimal disruption at the chair’s original trust.

More recently, the move towards system working, greater provider consolidation, and in some instances a drive to improve quality or become more efficient, has led a number of organisations to consider certain joint appointments including sharing a single chair for the medium or long term. In some instances this is a prelude to a more formal merger of acquisition, but not in every case.

This briefing examines the potential benefits and risks of more than one trust sharing a chair and includes reflections from a number of colleagues who have adopted dual chairing roles for a range of different reasons. Some of these benefits and risks are specific to the chair role, but many will be applicable to joint appointments in general.