Board member appraisal guidance

On 1 April 2025 NHS England (NHSE) published new board member appraisal guidance alongside forms for completion, gathering stakeholder feedback, and for the appraisee to use to prepare.

Intended to set clear expectations and enhance consistency in board member appraisals, the guidance applies to chairs, chief executives, non-executive directors (NEDs) and executive directors (EDs) in trusts, foundation trusts (FTs) and integrated care boards (ICBs).

The accompanying letter sent to chairs, chief executives and chief people officers of trusts, foundation trusts and ICBs sets out submission dates: ICB and NHS trust chair appraisals to be sent to NHSE by 30 June, and ICB and NHS trust NEDs’ appraisals by 30  September. These will be sent on to and endorsed by regional directors. Appraisal forms for all other roles (including FT chairs and NEDs) should be held locally.

If appraisals have already been completed or are underway for this year, they do not need to be redone.

The guidance is part of a suite of tools to support leadership and management development following the recommendations of the independent review on Leadership for a collaborative and inclusive future undertaken by General Sir Gordon Messenger and Dame Linda Pollard and published in 2022. It supersedes the Framework for conducting annual appraisals of NHS chairs published in February 2024 and incorporates the NHS leadership competency framework (LCF) domains and Fit and proper persons test framework for board members requirements.

This briefing provides a summary of the guidance, highlighting the key requirements, and NHS Providers’ view on them. For any questions about this briefing or feedback on the guidance, please get in touch with Izzy Allen at izzy.allen@nhsproviders.org.

This guidance sets out NHSE’s expectations and recommendations in the completion of board member appraisals and is intended to be adapted depending on the type of organisation and on whether the appraisee is an ED or NED.

The guidance sets out a number of ‘what’ principles, focused on what the appraisal should contain, and ‘how’ principles focused on how it should be undertaken. 

The ‘what’ of appraisals is that they:

• Are the culmination of ongoing dialogue, reviews and check-ins over the year.
• Incorporate the six domains of the LCF and feedback from multiple sources.
• Should look forward to the coming year.
• Set SMART objectives and include an equality, diversity and inclusion-specific objective.
• Take a developmental approach.
• Focus on the interaction between chairs and chief executives in appraisals for those postholders.

The ‘how’ of appraisals:

• ‘A partnership dialogue’.
• All stakeholders involved should conduct themselves in line with the values and behaviours of Our Leadership Way, the NHS People Promise, NHS values, the NHS Constitution, and the seven principles of public life (Nolan principles).
• Objective setting should be driven by the appraisee.
• Assessment should consider both the achievement of objectives and the behaviours and values displayed.
• A developmental review and plan should be agreed.

NHSE expects these principles to be adopted. Organisations may incorporate these principles into their existing processes or can choose to adopt NHSE’s process and use the forms provided. 

For those fully adopting NHSE’s process, it is clearly explained, and set out again in brief at the end of the guidance, along with related resources:

• Appraiser sets up appraisal meeting and requests feedback from multiple stakeholders.
• Stakeholder feedback is against the six domains of the LCF and the form provided can be used.
• The Scope for growth framework is suggested as helpful for both parties to review in advance.
• The performance expectations and professional responsibilities of the appraisee must be made clear.

The meeting itself should include:

• Performance review against LCF domains and previous year’s objectives.
• Discussion and agreement of next year’s objectives and a personal development plan.
• Assessment and declaration under the Fit and proper persons test framework for board members.
• Completion of the form by both parties.
• For ICB and NHS trust chairs and NEDs a copy should be sent to NHSE’s senior appointments and assessment team. For other roles, including chairs and NEDs in FTs, a copy should be kept locally.

A rating should be jointly agreed by the appraiser and appraisee. There are four rating levels for performance against objectives:

• Improvement needed – some objectives met
• Satisfactory – met all or most objectives
• Good – partially exceed performance standards
• Outstanding – Exceeds performance standards

There are suggested ratings to ensure the appraisal is approached holistically and values and behaviours are considered:

• Recognises – understands the importance of values and behaviours.
• Engages – upholds them in their role.
• Integrates – integrates them in decision-making.
• Advocates – champions and actively promotes them.

For executives only, there are ratings assessing the contribution to improvement (linked to NHS Impact):

• New to role/requires improvement – sometimes delivers improvement.
• Progressor – regularly delivers.
• Improver – consistently delivers.
• Sustainer – exceptionally delivers.

There follows brief commentary on the role of the senior independent director (SID) in chair appraisals. All trusts and FTs are asked to submit chair appraisals to the senior appointments team, and these will be signed off by the regional director, who may set up a review meeting if concerns are raised or if the organisation is in the recovery support programme.

The appraisal summary form provided requires appraisee and appraiser to agree a single summary rating based on performance against objectives only.

Effective management and leadership are essential to better outcomes for patients, better working conditions for staff, and well-functioning organisations. It is welcome that NHSE recognises this and is seeking to provide tools and frameworks to give board members the best chance to succeed.

The light-touch and flexible approach adopted in the guidance is a  welcome response to feedback on what was seen by some as an over-complicated chair appraisal framework in 2024, and makes sense when many organisations will already have well established, effective  processes in place. Trusts will wish to check their processes against the principles in the guidance. Both the ‘what’ and the ‘how’ should help ensure the appraisal process is valuable, constructive, and enables both recognition of an individual’s contribution and identification of any development needs.

The appraisal process set out is also straightforward and for the most  part clear. There is currently some contradiction within the guidance about whether FT chair appraisals must be submitted to NHSE: in the ‘process’ section it is clear that only NHS trust chair and NED appraisals should be submitted, but this appears to be contradicted in the wording of the ‘chair appraisal’ section later on.

Likewise, the role of the regional director in signing off FT appraisals is confused in this later section. It remains the case that NHSE has no statutory responsibility for the appraisal of FT chairs and NEDs.

The option to submit these appraisals should FTs wish is a sensible position (as set out in the letter accompanying the guidance).

The clarity provided by linking expected behavioural and performance standards with the LCF is helpful, as is the explicit inclusion of the FPPT review within the appraisal and, for EDs, links to NHS Impact. While it is unhelpful to have too many competing standards in play, the requirements of the well-led Care Quality Commission assessment and the Code of Governance are also important and could be referenced somewhere within the document.

It is particularly helpful to have a more consistent approach to appraisals at a time when the government is considering a new form of performance-related pay. While appraisals will always involve a degree of subjectivity, it is helpful to use the LCF as a standard framework, though worth noting again here, as per our briefing on the LCF, that the competencies do not lend themselves to simple nor consistent measurement.

The reference to inclusion of a specific EDI objective is also welcome, though the summary form does not remind the user of this fact. The EDI improvement plan is helpfully linked in a ‘useful links’ section
but could have been referenced, including the potential to link more explicitly to its ‘high impact actions’, where objective setting was outlined.

There are also a few more detailed areas for consideration by boards implementing the guidance:

• Trust leaders will wish to consider which elements are applicable to NEDs and chairs and which to executives only, and take a proportionate approach based on roles and responsibilities. Members will also wish to review whether alignment to the LCF enables full conversations about some of the technical skills required of chairs and NEDs in particular, for example chairing effective meetings and board development.
• The appraisal summary form only provides space for rating performance against objectives. Since a holistic approach includes values and behaviours, and the form provides an important record for the appraisee, trusts may wish to think about how they reflect values and behaviours in their paperwork or in individuals’ objectives, if using NHSE’s forms.
• Trusts that currently stagger NED appraisals based on appointment date may wish to think through the benefits versus disadvantages of this approach, and seek clarity from NHSE, if applicable, about whether trusts might conduct appraisals throughout the year and then submit the form to meet an annual deadline.

We are keen to receive feedback from our members on whether the guidance meets your needs and will share any feedback with NHSE.