National clinical directors (NCDs) lead specific national improvement effort in their field of clinical expertise where we determine that such extra effort is needed to provide better quality services in that specialty, or to deal with variations in provision or in outcomes. The typical NCD role is to identify the problems facing a specialty, build a consensus on how to solve them, and lead the change.
Since 2007 appointments of NCDs have been on a part-time basis, typically two or three days per week, and for a time-limited period, typically three years. The NCDs remain employees of their host organisation (typically a national health service trust) and are seconded to the Department for the proportion of their time they spend on their NCD role. This allows those appointed to remain active in clinical practice while serving as an NCD and also to return to their practice at the end of their term of office.
Appointments of NCDs are made through open competition, save in exceptional circumstances. Proposals to appoint NCDs are currently agreed by Ministers. In future any such appointment decisions will be the responsibility of the NHS Commissioning Board (NHS CB). The NHS CB will develop the criteria for recruiting clinical leads and for discontinuing any such appointments.