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Learning from board level leadership changes made in acute hospitals after...
Mon 10 April 2017, 12:00 – 13:15 BST
Learning from board level leadership changes made in acute hospitals after Francis: a national survey of NHS board members in England
Alan Boyd, Naomi Chambers and Nathan Proudlove, Alliance Manchester Business School (AMBS)
The national reform agenda for the NHS arising from the Francis report focuses on boards and leadership, including patient and staff engagement; and stronger external supervision of hospitals.
Previous research indicates that hospital boards can address how quality is managed, but some may lack capability to bring about service improvement and patient participation. Boards also perceive trade-offs between quality and financial balance.
The Department of Health has commissioned us to investigate how NHS hospital trusts have sought to improve board and organisational leadership in response to the Francis report, and to understand how boards can bring about service improvement in the face of various barriers.
As part of the research study, we conducted an online survey of members of boards of all acute and specialist hospitals in England in spring 2016. In addition we are in the process of analysing data from case studies of 6 trusts, which include document analysis, meeting observation, interviews and surveys of middle managers.
It appears that boards can have an impact on service quality and on patient experience. There is evidence that the recommendations about Duty of Candour to patients, in cases when there have been failings in care, have been implemented and a greater culture of openness is beginning to be embedded in the NHS. But financial constraints, poor local relationships and too much direction by central government or regulators may be limiting boards’ ability to fully exercise leadership in ways that would benefit patients and staff in their organisation.
Boards that emphasise the full range of key activities as suggested by governance theory may be more effective. Boards of lower performing organisations appear to place relatively less priority on engagement with external stakeholders, staff and patients and more priority on interactions with executives – both holding them to account and supporting them.
Alan Boyd is a Research Fellow at AMBS. He has research interests in the regulation and governance of healthcare organisations and professionals. He is currently involved in research evaluating the impact of CQC ratings of service quality, and of the revalidation of doctors.
Naomi Chambers is a Professor of Healthcare Management at AMBS. She is programme director for the Nye Bevan aspiring directors leadership development programme commissioned by the NHS Leadership Academy. Her research and teaching interests include healthcare board governance, health policy and leadership.
Nathan Proudlove is a Senior Lecturer at AMBS. His main interests are healthcare service improvement and data analytics.
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