Healthy NHS Board: a review of - NHS Leadership Academy

Research on board engagement, organisational culture
and human resources describe the potential harm of
stress in the workforce (The King’s Fund, 2012, McKee
et al., 2010). A review of staff wellbeing recommends
that wellbeing should be championed at board level,
and that strategies should be in place to improve
the health and wellbeing of the workforce. These
strategies should be adapted and added to reflect local
workforce need (Boorman, 2009). Research on human
resource management suggests that setting clear goals
that are understood at every organisational level is a
predictor of higher patient satisfaction (West et al.,
2010). As mentioned elsewhere (for example Section
3.4), staff wellbeing is associated with quality of care
and productivity and can be supported through such
processes as well structured appraisal, suitable staffing
levels, training, particularly when provided within a
patient safety-oriented culture (McKee et al., 2010, West
et al., 2010). This may support a ‘spiral of positivity’,
where staff commitment to the organisation is reflected
in patient outcomes and patient satisfaction (West et al.,
2010).
7.7 Culture and dynamics
While board culture and dynamics are increasingly
recognised as important, the related lessons on board
culture and dynamics presented in our original review
are broadly unchanged.
As described throughout this review, board culture has
been a focus of recent healthcare guidance and research
(Chambers et al., 2013, Department of Health, 2013c,
Francis, 2013).
Features of a healthy board culture include high trust
between members (Chambers, 2012) and capacity
to have open and constructive debate (Deffenbaugh,
2012). Board members’ emotional intelligence is
identified as important (Chambers et al., 2013,
Cornforth et al., 2010). This may support better
chairing of meetings and management of relationships
(Cornforth et al., 2010).
A review of research on engaging boards suggests
that a useful activity in strengthening board culture is
to spend time together away from the boardroom, for
example in terms of attending development days, but
also in social settings (Alimo-Metcalfe, 2012).
While the factors that influence how boards make the
decisions they make are clearly important, they are as
yet not well understood. The need for more research,
ideally using observational methods, is identified
(Bennington, 2010, Chambers et al., 2013).
34 The Healthy NHS Board, 2013: Principles for Good Governance