Case study

Board Effectiveness With A British Healthcare Foundation Trust

Context
  • This Board was under unprecedented pressure and also intense political and media scrutiny in light of several well publicized incidents. These challenges needed to be managed alongside the delivery of a sector leading model of integrated community-based care.
  • The Board’s performance had been impacted by frequent changes of Chair over the past five years. More recently, the NED and executive presence had also changed substantially in response to the scrutiny that the Board had been under.
Keynote Findings
  • NEDs did not have sufficient trust in executives due to a lack of sector experience and were therefore too detailed-oriented in Board meetings, derailing discussion.
  • There was too much overlap between committees, risking similar issues being discussed in different committees with varying solutions.
  • Pre-read content varied between insufficient or excessively detailed.
  • Public Board sessions were too lengthy, and stage managed due to the extreme scrutiny.
  • There was a need for greater focus on clinical governance, health and safety and record keeping.
Recommendations
  • Clearly agreed pre-read and reporting requirements.
  • Board sessions revised to consider length of and composition.
  • Reduction of Board size so that it could operate more cohesively.
  • Recruitment of additional NEDs with significant experience of the industry at senior levels.

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