Health Bill proposal an ‘attack on patient safety’

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 (see below).

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”.

She said she was “genuinely worried that we could return to those dark days where leaders look to cut nursing staff to make savings, putting financial targets above safety”. Nursing was “the safety-critical, 24/7 presence for patients”, Professor Ranger said, and removing its guaranteed board voice “would be a recipe for disaster”.

Read full story (paywalled)

Source: HSJ, 29 May 2026