Accreditation Decision Committee — Governance
The ADC makes all formal accreditation decisions. The supervisor recommends. The ADC decides. These functions are permanently separated — and that separation is permanently protected.
Permanent Safeguard 4: “ADC independence is permanent. The external majority requirement cannot be weakened.” Any change requires a two-thirds Board supermajority plus full ADC concurrence. The Board cannot override an ADC decision, cannot appoint the ADC chair, and cannot sit on the ADC. See the Seven Permanent Safeguards.
Composition
| Rule | Detail | Why |
|---|---|---|
| Pool size | Minimum 15 members; each decision panel 5–7 by rotation | Rotation prevents any facility from knowing its panel in advance |
| Independence majority | Majority must have no current employment or financial relationship with ASF | ASF cannot control the body that decides on ASF’s own accreditations |
| Clinical expertise | At least one member per panel with clinical background relevant to the facility type | A hospital decision panel includes someone who has worked in a hospital |
| Patient voice | At least one member per panel with patient-advocate background | Required by the Patient and Public Council’s formal rights |
| Exclusions | No active ASF supervisor, Coordinator, or Monitor may sit on the ADC | Assessment and decision functions permanently separated |
| Chair | Elected by ADC members — not appointed by ASF leadership | The chair answers to the committee, not to the founder or Board |
| Terms | 3 years, maximum 2 consecutive terms | Prevents entrenchment |
| Remuneration | Published rate — transparent, not discretionary | No financial leverage over members |
Voting Thresholds
The thresholds are asymmetric by design. It is easier to grant accreditation than to deny it — protecting facilities from single-member bias or procedural failure in the negative direction.
| Decision | Required majority | Why |
|---|---|---|
| Accredited | Simple majority | Recognition should not require unanimity |
| Conditionally Accredited | Simple majority | Standard threshold |
| Deferred | Simple majority | Standard threshold |
| Not Accredited | Two-thirds majority | Protects against single-member bias or personal animosity |
| Revocation | Two-thirds majority + mandatory notification + minimum 30-day response period | Highest consequence, highest threshold. Facility receives written notice and has 30 days to respond before revocation takes effect. |
The ADC Override
The ADC can commission an independent re-verification by an ASF-appointed Monitor — not the facility’s own Monitor — if it has substantive doubt about the Q4 report. This is the ADC’s tool for checking the assessment function without depending on it.
- If re-verification confirms the original Q4 report: ASF bears the cost
- If re-verification finds significant discrepancies: facility bears the cost, and the original Monitor’s credential is placed under review
Appeals
A facility that receives a Not Accredited or Deferred decision may appeal within 30 days. The appeals process is independent of the original decision panel.
| Element | Detail |
|---|---|
| Appeals panel | 3 members, none from the original decision panel |
| Scope of review | Process compliance only — did ASF follow its own rules? Not a re-assessment of clinical merit. |
| Timeline | Decision within 60 days of appeal submission |
| Finality | Final — no further internal appeal |
| External review | Independent judicial or regulatory review may be sought by either party under applicable national law |
| Cost | No fee for the first appeal. Subsequent appeals on the same decision are not accepted. |
What the ADC Publishes
- Aggregate decision statistics annually — number accredited, conditional, deferred, not accredited, revoked
- Anonymised decision summaries — the reasoning behind decisions, without identifying the facility
- Appeals outcomes in aggregate
- Panel composition rules and current pool size
- Member names and terms — in the conflict of interest register
Individual ADC member voting records are not published — decision independence requires that members can vote without external pressure.