Changing Role of Non Executive Directors in the NHS

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

2. 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

3. 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

4. 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 failureto positively Market or reputation manage

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. Excellent Book; • How to be an even better chair Sensible advice from the public and charity sectorsBy Sophie Petit-Zeman(in association with Common Purpose)available from the Common Purpose web site • http://www.commonpurpose.org.uk • Or from Amazon