28 May 2021 – NHS Non-Executive Directors webinar

This week’s session opened in conversation with Renuka Jeyarajah-Dent, NExT Non-Executive Director at South London and Maudsley NHS Foundation Trust.

Renuka said: “There is nobody in health, social care or education who would disagree in this post-Covid moment that collaboration, working closely with communities, building on existing relationships, prevention, person-centred care are the principles that guide us. Particularly in social care we have had the duty to collaborate since 2004 with safeguarding and we have learnt a lot from that that needs to be incorporated in this new duty to cooperate that we are now trying to implement quickly in this recovery stage of the pandemic.

“There are those who are hidden in plain sight that we’ve known about and this is what the cooperation is about; the adverse experiences usually in childhood abuse, of family relationships going wrong, domestic violence and also witnessing violence in the community, poverty and discrimination that make people feel outside our community and affect their life chances.

“They are hidden in plain sight but make themselves seen in our schools, nurseries and hospitals and what we are not doing is working together to cooperate in order to solve these problems as best we can, as early as we can before they become embedded.

“Local authorities see the NHS as centralised command and control and feel that the NHS need to devolve power and resources and not simply delegate functions through commissioning. They’re fearful that the ICSs will be more centrally operated, that we will lose the granularity and community representation. They see NEDs and boards as appointed and do not see us as representing their people. They feel that we need to be looking at legal form in this duty to cooperate rather than function. They want reciprocal cooperation.

“The NHS is a brand in which every citizen in this country unites. There is no one that I have met in this country that isn’t proud of the NHS as a symbol for cooperation and we should harness this.”

Also overheard during today’s webinar:

“The anticipated ICS legislation will hopefully clarify the duty to collaborate. There is a very important point to be made regarding commissioning and the role of the voluntary sector. In many cases commissioning is going back to the NHS trusts from the CCGs or other commissioners and there are governance implications, systemic issues and policy concerns around this. The reforms do not extend as much into the changes needed to the commissioning framework. In addition, as NEDS our contributions to date are diminished in the ICS developments. With our arms tied and blindfolded – what practical steps can we take?”

“There is much more movement and understanding through the ICS. They have brought people together but what’s important is that we carry on with what’s happening and don’t get distracted by some of the issues in the legislation. Our ICSs are in a much better place than they were with the relationship between local authorities.”

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 website https://www.good-governance.org.uk/events/.

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