Board Development

Key Areas

• Purpose of Governance?
• Code of Conduct
• The Role of NHS Boards
• Improving Board Effectiveness
• Citizen Engagement
• The Roles of the Chair
• The Role of Executives
• The Role of Directors
• Good Board Practice
• Stakeholder Relations
• Due Dilligence

The role of NHS boards

NHS boards are made up of Independent Members and Executive Directors acting as stewards of the organisation’s resources and responsible for overall governance. The board should act as the controlling mind of the organisation. The board should agree a vision, develop and set a strategy, exert leadership, ensure accountability and transparency and ensure that the executive of the organisation is held to account.

Key points:

• A board is where all directors, whether executive or independent , come together in their role as directors of the organisation concerned. All hold equal responsibility in their board role, and none should act in a tribal fashion as a member of the executive or independent team.
• Building on this, however, independent members have the prime responsibility to support their executive colleagues by holding them to account for their actions, and constructively challenging their assumptions in order to get the best possible outcome.
• Executive directors perform a dual role, which we expand upon in our section on the role of executive directors.
• Boards govern, management manages. Boards should understand the difference between the governance and management roles. However, NHS boards need to have a line of sight to the services they are responsible for.
• NHS boards act on behalf on many stakeholders. These include the patients who use their services, taxpayers who provide the resources, government that sets overall policy and partners who are essential to providing the complete pathway of care.
• Boards are the frontline regulators, and should at all times satisfy themselves that their organisation is acting within the law, abiding by agreed codes of practice and meets all relevant compliances.
• Boards are responsible for defining the culture and setting the values for the whole organisation.

Link: - University of Leeds inquiry into NHS boards www.cihm.leeds.ac.uk/new/2009/07/national-governance-inquiry-launched-today/

Link: - Institute of Directors www.iod.com/intershoproot/eCS/Store/en/pdfs/policy_paper_governance_nhs_trusts.pdf

Link: - Monitor and Mid-Staffordshire – when a board fails www.monitor-nhsft.gov.uk/home/news-and-events/media-centre/latest-press-releases/monitor-response-professor-sir-george-albert