This briefing provides a summary of the requirements of the fit and proper persons regulations (FPPR) and offers practical suggestions for how trusts can ensure their policies and procedures comply with them, as well as meet the expectations of the Care Quality Commission’s (CQC) regulatory approach. These suggestions cover how trusts could assure themselves that their directors are fit and proper at the appointment stage, at regular intervals throughout their employment and if concerns are raised about them.

Since the introduction of the FPPR, several trusts have conducted investigations into concerns raised about their directors that fall under these regulations. Due to the complexity of such concerns, each individual case is different and trusts must address such concerns depending on the individual circumstances. This briefing highlights what trusts should take into account when considering whether to undertake an investigation, and what they should be mindful of at each stage of the process.

The following top tips summarise the advice gathered from trusts that have already conducted investigations into FPPR concerns:


1. Establish robust employment processes and procedures, and regularly review them, as this saves time and money further down the line.
2. Be committed to openness and transparency in all FPPR related processes and throughout an investigation.
3. Seek expert legal, HR and other relevant advice as appropriate.
4. Consult with CQC and NHS Improvement counterparts as much as possible throughout the investigation process.
5. Agree the terms of reference and timescales of the investigation at the outset.
6. Consider how the wider organisation should be involved in the investigation, including NEDs and, in foundation trusts, governors.
7. During the investigation, engage with everyone involved in the concerns, including those who raised concerns or may have an issue with the outcome, and make sure they all have a voice.
8. Communicate the progress made by the investigation well so that all parties feel involved.
9. Consider how to manage the outcome before it is made public.
10. Be really clear about the outcome of the investigation, the reasoning behind it and any necessary action.