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Enhancing system leadership: The key role of non-executive directors

Words by Kevan Taylor and Dean Royles. Kevan and Dean offer their expertise to organisations and systems by providing strategic support, advice and development.

The run up to the general election provided much speculation and many promises about the NHS - more staff, more hospitals, more upgrades, faster GP appointments.  It seems it is a unique feature of our politics that the NHS is such a hot potato and such a political football for good and for ill. It is fantastic that the NHS, as a well loved institution, gets the limelight in election campaigns and manifestos, more investment often follows. However, it also creates constant speculation about the priorities of the NHS and how it is structured, creating uncertainty for staff, patients and healthcare leaders alike. It can be hugely frustrating.

Post election, speculation has now settled down. We can expect more announcements about nursing expansion and hospital new builds. That’s what new governments do. Importantly, we also know that Integrated Care Systems (ICS) are here to stay... until the next general election, at least!

The consolidation of ICSs as healthcare system drivers and enablers, means more investment in system leadership development. The way leaders work together collaboratively, is hugely important to the way any system works. The more mature the relationships between organisations and leaders, the more effective the system as as systems seek to become more transformational and to improve performance, this will become evermore important.

However, in our roles, as we engage with leaders, we often hear that decisions made in good faith by system leaders can come undone when they land back in individual organisations. Boards and, in particular, NEDs (and governors) as well as governing boards can feel uncomfortable and uncertain.

To some extent, this is no surprise. NEDs have a statutory responsibility to the organisation they are appointed to. Job descriptions and adverts often  make it clear that their accountability is to their local population and to the the organisation, there is often little reference to system working. Yet they are an untapped source of system knowledge and expertise. We need to engage them more in system leadership, enhancing and building on their organisational roles. They are often experienced directors from the public, private and third sectors with many skills not that common in the NHS and, they are committed to making things better for patients. They have skin in the game.

We can involve them more in;

  • - System Leadership work
  • - NED development programmes
  • - Peer networks
  • - Action Learning Sets
  • - Engagement programmes

Bringing their knowledge and expertise into the organisational development and design of integrated care systems.

They really could be key to unlocking our system performance and transformation.

We know from our conversations with Chairs, lead governors and governing bodies, that despite the obvious pull of statutory obligations and time constraints, there is significant appetite amongst NEDS, Governors and Governing Bodies to make a difference at system level. They know we get the best for patients when we work effectively in partnat system level.


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