Healthy NHS Board: a review of - NHS Leadership Academy

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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
8 Conclusions This review was commissioned to support development of the updated guidance, The Healthy NHS Board 2013: Principles for Good Governance. As with our original review, we aimed to bring together lessons from guidance and research that might support effective board governance. This information was drawn from healthcare and nonhealthcare domains, with an international scope and a particular focus on the English NHS. Although this review is not exhaustive, we found much guidance and research to enhance our appreciation of the roles and duties of boards and our understanding of how they add value to the organisations they lead. Based on this information, we have identified lessons that we hope will be of use to NHS board members. Evidence and guidance on board roles and the building blocks of effective governance have increased since our original review was published. Our updated review suggests that certain issues have gained prominence since 2010, notably the prioritisation of the quality of care and the increasing extent to which stakeholder engagement is valued. Also, in the context of NHS Foundation Trusts, the developing role of governors has relevance to many aspects of board governance. In our original review, we noted that there were several domains in which we could not draw firm conclusions. For example, associations have been found between board characteristics, board activity, organisational behaviour, and aspects of quality and performance. However, the nature and direction of causality in these associations frequently remains unclear. To reach an understanding of these important matters, further research is required. Writing this addendum to our original review has provided us with an opportunity to engage with a wide range of research and guidance on how boards govern and add value to the organisations they lead. We hope this represents a useful contribution to refreshed guidance that will continue to support the important roles played by NHS boards. www.leadershipacademy.nhs.uk 35
Page 1 and 2: The Healthy NHS Board 2013 Review o
Page 3 and 4: 6 Board committees ................
Page 5 and 6: The building blocks of governance T
Page 7 and 8: 2 Introduction 2.1 Purpose and stru
Page 9 and 10: Author Title Year Summary Chambers,
Page 11 and 12: Author Title Year Summary Fulop, N.
Page 13 and 14: Author Title Year Summary Storey, J
Page 15 and 16: 3 Role of NHS boards The English De
Page 17 and 18: 2012, Committee on Standards in Pub
Page 19 and 20: 3.3 Shaping culture The board role
Page 21 and 22: Innovation Recent guidance describe
Page 23 and 24: Equality and diversity The need for
Page 25 and 26: 4.3 Engagement Our previous review
Page 27 and 28: Engaging partner organisations Enga
Page 29 and 30: 5.3 Non-Executive Directors Updated
Page 31 and 32: 7 Building board effectiveness Many
Page 33: 7.5 Processes A review of the liter
Page 37 and 38: De Vos, M. L., Van Der Veer, S. N.,
Page 39 and 40: 10 Acknowledgements The authors wou

Healthy NHS Board: a review of - NHS Leadership Academy

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