Transcript Changing Role of Non Executive Directors in the NHS

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
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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
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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
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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
• http://www.commonpurpose.org.uk
• Or from Amazon