The Department of Health (DH) has published Niall Dickson’s final report and the DH’s own response to his recommendations in relation to enhancing confidence in healthcare regulators.
A significant dimension to the report relates to the development of effective boards.
At Appendix 3 of the publication is a report on the characteristics of effective boards by the Council for Healthcare Regulatory Excellence (CHRE). The CHRE report is based largely on John Carver’s book Boards That Make a Difference, which, they say, “offered the most relevant and sensible advice, focussed on the public/not for profit sector, and widely respected.” The CHRE offer, based on Carver’s work, “12 key principles of an effective board” as follows:
1. The board should determine the purpose and values of the organisation, and review these regularly
2. The board should be forward and outward looking, focussing on the future, assessing the environment, engaging with the outside world, and setting strategy
3. The board should determine the desired outcomes and outputs of the organisation in support of its purpose and values
4. For each of its desired outcomes and outputs, the board should decide the level of detail to which it wishes to set the organisation’s policy
5. Any greater level of detail of policy formulation should then be a matter for the determination of the chief executive and staff
6. The means by which the outcomes and outputs of the organisation are achieved should be a matter for the chief executive and staff; the board should not distract itself with the operational matters
7. The chief executive should be accountable to the board for the achievement of the organisation’s outcomes and outputs
8. In assessing the extent to which the outcomes and outputs have been achieved, the board must have pre-determined criteria which are known to the chief executive and staff
9. The board should engage with its ownership regularly and be confident that it understands its ownership’s views and priorities
10. The membership of the board should be capable and skilled to represent the interests of the ownership; this should not be done in a tokenistic way
11. Information received and considered by the board should support one of two goals – to enable decision making, or to fulfil control and monitoring processes
12. The board must govern itself well, with clear role descriptions for itself, its chair, and its members, with agreed methods of working and self-discipline to ensure that time is used efficiently
Paul Stanton, former Director of Board Development at the National Clinical Governance Support Team, has recently stated in a Health Service Journal article, that his own thought on good governance are “influenced by the work of John Carver, whose model of ‘policy governance’ is admirably clear……….” (see Healthcare Governance Review post here).
Download a copy of the publication Enhancing Confidence in Healthcare Professional Regulators – Niall Dickson’s final report and DH response to the recommendations here.