20 May 2021 - Mental Health Network – governance during the COVID-19 pandemic webinar

Overheard during the webinar:

“Our system is developing initiatives, including one on training and recruitment where we are going into a collective with local training colleges and universities to improve the quality of training and meet the local solution. They are looking for chairs to lead this and there is a concern that chairs are being pulled in more and more directions as the system develops.”

“I agree that this is a challenge. Some chairs are being pulled on more than others without consistent pay or responsibility allowances. Non-exec directors do bring a huge range of skills and experience which would make them good candidates to lead this, but without additional remuneration it devalues the role.”

“There are huge assumptions being made about chairs and indeed NEDs adding time to new ICS structures, where previously either execs or consultancies would have performed similar roles on a paid basis. There are also simultaneous assumptions that NEDs will be playing a bigger role in community-level fora as we appear visibly in place as well as leading work in system. Personally, I am giving up other work this year to fill this unique window of NHS demand and opportunity, but that is not a sustainable solution.”

“Chairs can also sometimes be judged based on the performance and understanding of the role from a previous chair’s approach, which can make it difficult as a new chair to shape the role as your own. This can include the idea of being in the trust too often or dedicating too many days to the trust.”

“We are in a context that demand on time can only increase, with place-based partnerships, systems and provider collaboratives. There is a gap of non-executive scrutiny, and it is unclear where people will come from to fill these positions. This will be either through direct appointments or existing NEDs.”

“There seems to be a wide range of approaches to place in ICSs. In Lancashire they are looking at place-based boards, which will have relationships with other boards. In Merseyside, they are seeing the health and wellbeing board as the place-based board.”

“I don’t feel that the health and wellbeing board can be the same as the place-based board if that is delivery focused. In Buckinghamshire, they see budgets and decision-making held at place, which would need a specific structure – which a health and wellbeing board wouldn’t be able to do. They are developing a maturity matrix around place, which he can involve people and share round.”

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