26 November - non-executive directors

This week’s session began in conversation with David Rogers, Chairman, North Staffordshire Combined Healthcare NHS Trust.

Overheard during the discussion:

“The CQC is gradually changing its approach so that when well-led reviews kicked off, they used to be really an accumulation of the work done before this which was to take lots of data and examine this for things that didn’t look right. These issues that didn’t look quite right were then areas for further discussion. There wasn’t a commitment to figuring out whether the culture of the organisation was right and whether the leadership was appropriate in its ambitions. Its only in the last year or so that the CQC has changed its ways.”

“They will now put other chairs of other trusts on the team reviewing and sandwich interviews into a day or two and they will be more about ambitions and whether these are appropriate and more about the quality of the leadership but unfortunately only the leadership at the top rather than leadership right the way through the organisation.”

“It’s a moving target to say how do we encourage the CQC to help us on our way. The only real answer to this is that you try to get close to them and create a relationship where they are there to help and support you, to point you in the right direction and offer you advice in a timely manner and if you get this right then you are on your way to improving.”

“You need to have diversity of outlook, ambition and appetite on a board to avoid big group think and make sure that people aren’t in awe of large personalities on the board that disappear after a few months.”

“We have been reflecting on a similar process as our CEO has just left. One of my colleagues described it as; a new CEO came in when our trust was in special measures and he dragged it out of the iceberg, with some damage both due to the iceberg and his pulling it out. He left and the next settled the Trust down and the third who has just left steered us into new waters. I think this recognition of the different stages is important and it may need to rest with different people, certainly with different styles.”

“We need to fast forward to 2024 and imagine that we would be sitting in this room with the same people – what will excellence be like then? Excellence for who and why. Different types of organisations have different contexts of excellence for example mental health trusts, acute trusts etc. They all operate within different regulatory environments.”

“Excellence can only be measured in the experience of and outcomes for the people who use the service. The excellence of the organisation is only in service of that, not an end in itself.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation. For further details, visit our events page.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk