Changing Role of Non Executive Directors in the NHS WHAT MAKES A GOOD NED A GREAT NED

Zenna Atkins –Chairman Portsmouth City Teaching PCT –Chairman Places for People a commercial and Social Neighbourhood Developer and manager –NED Royal Navy & Chairman of FLEET audit committee –Chairman Dreamwall a Social enterprise changing the lives of young people –Executive consultant Social Solutions company supporting new business and Social change

NHS Context - 10 Year plan AIMS –Primary care lead –Clinically driven –Locally recognised geographical coverage –Locally & Financially Accountable –Transform health away from secondary care Ministerial and Centrally perceived failings –Not delivered fast enough –Financial gains not realised –Decommissioning of Secondary care not holistically achieved –Leadership failure

NHS Context – My Perception of Critical Failings No serious, central or sustained investment in culture change to support the new direction A critical failure of organisational governance Chairmen and boards were not held to account for their actions No sensible or consistent failure regime, organisations that failed financially or on performance were bailed out Successfully organisation were not supported or celebrated The NHS uses a very limited portfolio of management tools relies to heavily on command and control A failure to positively Market or reputation manage

Effective Boards Understand and can clearly articulate their statement of purpose Always focus on the delivery of purpose Clear scheme of delegations Excellent at holding to account Understand and implement good governance Understand and act within the operating framework Have evaluation and appraisal processes Does what it says on the tin within the agreed financial framework

NHS BOARDS Are held in Public Have clinical involvement Membership is externally prescribed Politicians set their strategy Politicians/Centrally increasing directing not only the what but the how Have to consider “political reputation” Have ambivalent and changing success criteria Have unearned income Have resource limits

A GOOD CHAIRMAN Structures Agendas Keeps to time Encourages probity Is clear about their role Supports but does not collude with the CX Keeps the board focused on the purpose and outcome within resource limit Is personally accountable Supports the NEDs and gives clear role and function direction Is not there for their own ends

GREAT NED’s in the NHS Keep focussed on the purpose not the organisation Has always read the papers BEFORE the meeting Holds executives to account Moves Executive thinking on with out being a “consultant” Understands the strengths and weakness of the executives

GREAT NED’s in the NHS Spots the Gaps Is not in love with the sound of their own voice Knows the difference between constructive challenge and point scoring Understands what is in the public interest Understands the public sector environment but does not go native

GREAT NED’s in the NHS Is able to take the flack Knows and values what an Audit committee does Works as a team Keeps informed with out pestering Is clear about their own motivation Understands the political direction and is clear about the local accountability

GREAT NED’s in the NHS Is entrepreneurial and creative in their thinking Knows the operating framework Knows their own limitations and plays to their strengths Is outward looking and informed about the wider context Is not self protectionist

Excellent Book; How to be an even better chair Sensible advice from the public and charity sectors By Sophie Petit-Zeman (in association with Common Purpose) available from the Common Purpose web site Or from Amazon