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The Francis and Keogh reports highlight the need for good governance and effective Non-Executive Directors in the NHS
Both Francis and Keogh reports have highlighted the crucial role played by Non-executive directors in the NHS.
Questions about standards of nursing care, above average mortality rates and low staff morale are continually being asked by the media – increasingly turning the spotlight on the governance of the NHS.
Patients, carers, doctors, nurses and managers are concerned and anxious about the level of care they can either expect to receive or that they are able to deliver. The Care Quality Commission, the body which is supposed to provide an independent assessment of quality in NHS trusts, has been discredited over its failure to spot departures from acceptable standards of care in several high-profile cases and there is a degree of confusion in other regulatory bodies as they struggle to find their way in the newly transformed NHS.
NHS staff, already feeling the pressure of having to deliver more services and reduce costs, are now having to deal with the added burden of having to reassure patients and carers that theirs is not a failing trust.
NHS Non-Executive Directors are the eyes and ears of the outsider with privileged access to the inside of the Hospital, Mental Health or Community Health services upon whose board they sit. Together with the Governors (in a Foundation Trust) or the Staff Council (in a Social Enterprise) they are responsible for ensuring that the trust is governed effectively.
Speaking on Quality governance the Keogh report says:
“Too often our reviews found quality issues of which the board were unaware. whilst many boards could point to improvements in quality governance processes (e.g. undertaking walkabouts in the hospitals), review teams were concerned that boards could too easily accept the assurances they were receiving and were not really listening to contradictory evidence or seeking more robust assurance. in some cases, the non-executive directors and chairs of the trusts were not providing appropriate critical challenge to the management team.”
One of the recommended actions from the report is that:
Monitor and the NHS Trust Development Authority should consider the support, development and training needed for Non-Executive Directors and Community, Patient and Lay Governors to help them in their role bringing a powerful patient voice to Boards.
So what makes a good NHS Non-Executive director?
- NHS Non-Executive Directors must have a clear understanding of their role and how they can most effectively serve their trust.
- They must ensure the trust is governed properly: that it complies with the right laws and regulations, that its strategies are robust, its business plans achieved and that stakeholder and patient interests are protected.
- Non-Executive Directors must be independent minded, have integrity and gain the respect of other board members. Despite their personal liability, they need to step back from the detail (having satisfied themselves that there is a robust management, information flow and performance management structure in place at executive level) and be prepared to look at the trust’s business from a “big picture” perspective.
- Time is an important factor. Most advertisements for NHS Non-Executive Director vacancies talk of a commitment of two to three days a month – the reality is often double that number. Especially now, with the spotlight on NHS governance, Non-Executive Directors should be prepared to spend enough time on the job to ensure that they are effective and well informed on the key issues faced by the trust.
- Non-Executives also need the ability to wade through papers and other statistics and elicit the knowledge they need to perform their role effectively without being overwhelmed by detail. In fact, detail is often the enemy of the Non-Executive Director.
- Chemistry with fellow board members is also vital. That does not mean bending over backwards so everyone gets along but rather conducting themselves in a mature and professional manner and being prepared to monitor the activities of the trust and challenge the performance of the organisation and its executive.
- Non-Executive Directors should keep in touch with fellow Non-Executive Directors to share best practice between meetings, as well as immerse themselves in the trust’s business in the early days, asking lots of questions before forming opinions.
- Assertive judgements or challenges based on ignorance or misinformation will not enhance the image of a Non-Executive Director and only damage their credibility.
- In terms of the board and particularly the executive team, the role of a Non-Executive Director is to offer advice, challenge and apply sound governance. The challenge is to do that as part of the team rather than appear as someone standing outside and criticising without an appreciation of the tough job the executive team has to do. The executive team must also be open and keen to take on board advice from Non-Executive Directors.
- The best Non-Executive Directors are those with strong influencing skills, good powers of judgement, insight and vision, and good listening skills. It is also important to be committed and enthusiastic about the trust and to inspire confidence. Showing that you are level headed will help boost credibility and respect.
- Good training is important in developing Non-Executive Directors – there should be a training programme in place together with personal development plans. This will help to identify each board member’s particular skills, how they can be used and developed and which skills are missing across the board.
Assuming you have all of the above critical qualities how do you then make sure that you are an effective member of the board?
The keyword is assurance – how do you know that what is being said at board meetings is the whole picture?
You need to triangulate the information you are receiving from a number of sources to give you a feeling of how the trust is performing – much of this triangulation happens outside the boardroom, which is why being a Non-Executive Director is so much more than just attending board meetings or reading the board pack.
As an NHS Non-Executive Director you should make it your business to visit every area of the organisation – hospital wards, clinics, departments and anywhere that services are delivered. Try to visit at different times of day and night and on different days of the week – especially at weekends. Introduce yourself to the staff on arrival and then, quietly and unobtrusively, observe what is happening. You may think this is impossible: that managers will resent you and feel undermined, that staff will behave differently because you are there, that you ought not to disturb patients. Remind yourself, when you need to, that your role is different from the managers’, because you are not compelled to take action. You have a right and a responsibility to use your eyes and ears: sit or stand quietly to one side, for only a few minutes and you will be surprised at how quickly people forget you are there.
When you do so, you will see for yourself the welcome patients receive; whether they can see the name of the person dealing with them; whether and how staff introduce themselves. You will see if you can tell from the uniforms who is who, and what their role is. You can look for the written information for patients that is available to staff on the wards; you can see the quality of the physical environment and feel the atmosphere.
Introduce yourself to patients and relatives – find out if they know who is in charge of their care and how they can contact that person should they need to. Talk to the staff – find out what they think of their area of work and of the hospital. What do they like and what frustrates them? What would they like to change and why, and what do they feel they can do about it?
Make sure that the trust executives are aware of and supportive of these visits. If you find that you are a member of a board which is uncomfortable with Non-Executives talking to staff, patients and carers then raise this as an important board matter. It is impossible for you to effectively discharge your duties as a director if you are not encouraged to find out about the culture of the organisation at first-hand.
For the most part, what makes a good NHS Non-Executive Director is pretty much the same as what makes any Non-Executive Director effective. The difference is that the NHS has the power to dramatically effect people’s lives much more than probably any other organisation in the country.
What makes a good NHS Non-Executive Director is the realisation that along with your fellow board members you are responsible for ensuring that the trust delivers the highest standards of patient care.
Use this checklist to see if you have the skills Non-Executive Directors need to be effective
Regardless of any specialist expertise, Non-Executive Directors must be independent, have integrity and the respect of the other board members, be prepared and able to look at the business from a ‘big picture’ perspective, be well-informed and manage difficult decisions in a facilitative manner.
The chemistry with other board members is vital. It is the Chairman’s responsibility to ensure that the Board functions as a team, with the NEDs functioning as a cohesive unit within the Board team.
NEDs should act in a mature and professional manner and be prepared to make a stand if they do not agree with the way the organisation is being run. Increasingly NEDs are obtaining professional qualifications such as the Institute of Directors’Chartered Director qualification to demonstrate that they have the understanding and experience to undertake their non-executive duties in a thoroughly professional manner.
Examples of how you demonstrate the following skills are commonly asked for when applying for Non-Executive Director positions:
- Integrity – high ethical standards
- Sound judgement – willingness to challenge
- Interpersonal skills – listening, persuasiveness, ability to communicate ideas, sensitivity, openness and awareness of non-verbal communication, co-operation and team-working, facilitation skills
- Leadership and self-awareness, ability to gain respect and attention, confidence
- Critical thinking, creativity and strategic awareness – the ability to take the wider, strategic view
- Business acumen, ability to identify new business opportunities, embrace change and innovation
- Ability to assimilate, assess and analyse information, especially financial information
- Political astuteness, diplomatic, able to deal with conflict
- Determination, with the tenacity and drive to succeed
- Keenness to gain new knowledge and skills to develop competences further
The list above is not exhaustive but highlights the important skills you will need as a Non-Executive Director. Along with your knowledge, background and experience, these skills will equip you to be an effective member of the Board in either the private, public or voluntary sector
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A Non-Executive Director CV is different from an Executive CV
The skill-set required to be a successful Non-Executive Director is different from an Executive Director’s skill-set so it makes sense that your Non-Executive Director CV should be different from one you would use to obtain an Executive position.
A summary of the skills needed to become an effective Non-Executive Director can be found here. Your NED CV will need to demonstrate that you have these skills by drawing examples from your current and previous executive and non-executive roles.
Because of this need to provide more evidence about how you match up to the NED skills criteria there is some acceptance that the usual requirement for a strict 2 page CV can be relaxed and that a NED CV can be between 2 and 4 pages long. This is not universally accepted though and some recruiters will still demand a full chronological executive type CV with a 2-page limit.
Your NED CV should contain the following:
- Your contact details on the 1st page with your address, email and phone numbers. It is a good idea to have your e-mail and telephone number in the header or footer of the CV continuation pages.
You should have a LinkedIn profile and provide the address with your other contact details. It is important to make sure that your LinkedIn profile and your CV are consistent with each other – there should be nothing in your CV that is not in your profile and visa versa. The level of detail does not have to be the same though and your CV should be the more concise of the two.
- A candidate profile, summarising the key skills, or useful experience you have to offer to a Board as a Non-Executive Director or Chair. This should be less than 6 points and not more than 8 and should highlight areas of your experience which demonstrate that you have the required skills.
Recruiters will be looking for a mixture of NED boardroom skills such as ‘Strategic Evaluation’ or ‘Risk Management’ and some personal areas of expertise that a particular organisation may require for its Board such as ‘expertise in digital marketing’, ‘strong IT product development track-record’, ’10 years’ experience of luxury goods sector’, ‘Finance Director experienced in VC/EIS fundraising’, ‘NED with IPO and AIM-listed company experience’, ‘Experience of Chairing PE backed companies’.
The candidate profile is probably the most likely part of your CV that you will want to tailor when applying for a particular role.
- Your current and previous Board-level experience as an actual Chair, or Executive or Non-Executive Director. You can also include here any experience you may have had acting as a board-level consultant, Company Secretary, Trustee or Governor.
In particular, you should mention any formal Board subcommittees, such as Audit, Finance, Remuneration, Nominations or Governance that you have either Chaired or were a member of.
If your role was not as a Companies House registered director you will need to explain the nature of the Board and how the experience you gained in the role is relevant to being a Non-Executive Director.
You should also mention here any qualifications you may have such as Chartered Director from the Institute of Directors or the Financial Times NED diploma. If you have attended a course or workshop such as the Excellencia How to become a Non-Executive Director course. to prepare yourself for the role that is also worth mentioning.
- A complete and accurate career record with dates and a description of your major achievements and responsibilities in your more important roles. Minor/brief/early roles can simply be mentioned without descriptions. Career breaks are not a problem so do not try to hide them. The career record should not only say what you have done but also back up the skills and expertise you claimed in the first section. Again make sure everything is truthful and accurate.
- A summary of your relevant professional, educational and technical qualifications, especially any that would be relevant for a particular Board appointment or Board subcommittee – such as an accounting qualification for an Audit Committee.
You will often be asked to provide a CV in word format, if you are given the opportunity to provide one as a pdf, then take it as it ensures that your CV will be formatted and print out exactly as you intend it to be
As with all job applications there are no hard and fast rules covering the format and content of your CV. Try to see your CV with the eyes of someone who is wanting to make a Non-Executive Director appointment – think about what they are looking for and whether your CV has demonstrated that you have the knowledge, skills, background and experience to be an effective NED.
The Chair of a Senate inquiry into tax avoidance, Labor Senator Sam Dastyari, explains why he wants tax-dodging businesses to be named and on a public register.
Are you thinking of becoming a Non-Executive Director as part of a Portfolio Career or to develop your boardroom skills prior to taking up an executive director role?
Join us on Wednesday, September 23 2015 to find out how you can become a Non-Executive Director
“Unlike many courses I have attended in the past, How to become a Non-Executive Director went beyond just the technical aspects of being a ‘Non-Exec’, and reflected on the differences in the approach required compared to being an Exec Director.
It allows you to make a fully informed decision on whether a Non Exec role is right for you, and if it is, how to go about finding opportunities.
An invaluable day of learning!”
Alastair Lewis Director at Smaointe Ltd
The How to become a Non-Executive Director course helps you to plan and prepare for your first NED position. It instils a real sense of what is expected of NEDs, and how you can meet the challenge.
This one-day interactive course is aimed at aspiring NEDs and covers essential knowledge about roles, responsibilities, strategy and corporate governance that are key foundations for a Non-Executive board role. It also considers up to date thinking on corporate governance and the responsibilities of owners, the board and employees.
This is followed by practical sessions on identifying NED opportunities, the process of obtaining a first appointment and performing due diligence before any position is accepted. There is emphasis on the importance of presenting your experiences with clarity and relevance.
This course identifies the various ways and circumstances in which non-executive directors can make an effective contribution to a board’s work. It also examines methods for their selection and reviews their motivation, induction and reward.
A Chartered Psychologist has been recognised by the Australian Psychological Society’s College of Organisational Psychologists for an innovative programme to promote effectiveness in a telecommunications company.
The programme was designed and implemented by Pauline Willis, a UK-based occupational psychologist, and Dr Josephine Palermo (General Manager, Customer and Collaboration, Telstra Corporation). Telstra is the largest telecommunications company in Australia and has a presence in over 15 countries. Willis told The Psychologist: ‘Collaboration is widely recognised as being critical to business success, in the global economic environment where the digital economy is creating new challenges. Feedback from both Telstra staff and customers identified the potential detrimental consequences of working in silos to both customer experience and employee engagement. By harnessing organisational psychology, we designed a program that raised awareness of the importance of collaboration and developed a culture of collective or shared leadership.’
The Workplace Excellence Awards celebrate exceptional achievement and innovation in the application of psychological principles in the workplace and recognise best practice in organisational psychology.
Photo: Pauline Willis. Credit: Nick Rawle.
Pauline is co-course leader on Excellencia’s Becoming a Non-Executive Director – for Coaches and Mentors course – the next one is in Oxford on Tuesday 15 September 2015
The Becoming a Non-Executive Director – for Coaches and Mentors course is designed for coaches, mentors and other professionals who possess these skillsets including organisational psychologists and business consultants. It is also of value to anyone who has substantial experience and expertise in harnessing individual as well as team effectiveness at board level, and who is experienced as an Executive Director or CEO.
Coaching and mentoring skillsets are different from those which are typically sought for the NED role. Bringing these skillsets into the boardroom as being valuable in themselves, provides considerable scope for increasing the diversity, well-being and effectiveness of organisations in the current volatile, complex and uncertain economic climate. HR professionals and recruiters seeking to appoint NED’s from a wider selection pool will also find this course valuable in providing what they need to support their clients in making informed decisions.