‘Governing the NHS the independent way’

Onmedica carries an interesting article from Dr Ade Adeagbo, Chair of the Non Executive Directors Network, NHS Alliance.

Dr Adeagbo believes that “For the NHS to achieve QUIPP and ‘Nicholson Challenge’ it must have a governance system that requires from the health and care systems, fundamental changes in the way care is provided and managed. This form of governance is revolutionary, based on first principles, with strategic focus on the future of a NHS that can achieve large scale change.”

He further believes that “Independent Executive Directors are the enablers to achieve a clinically led, outcome oriented and patients’ centred NHS.”

In his article in Onmedica he sets out what independent directors will bring to clinical commissioning boards and identifies the key attributes of the role of independent director.

Read Dr Adeagbo’s article Governing the NHS the independent way here.

7 Responses to ‘Governing the NHS the independent way’

  1. Paul Johnson says:

    An excellent article. I am also concerned that those who sometimes display the least understanding of gobvernance – the government – will miss this opportunity to reflect on both the advances in governance theory, research and NHST/FT experience and put in place the necessary requirements.

  2. Peter Reeves says:

    It is hard to see how an Executive can remain ‘independent’. What about the need to work with exec colleagues and be accountable to the CEO, for example? The article’s conclusions surely point to the need to strengthen the role of non-exec directors – who, alone, can apply judgments that are truly ‘independent’. BUT they need ‘industry’ experience – the generalist is soon lost within the peculiarities of the NHS system/culture – and more time (and commensurately more pay) to do the job effectively

  3. Anonymous says:

    Peter, if a CEO made it clear that he expected the EDs to challenge each other and not leave it to the NEDs, would that not work? Whilst everything that comes before the Board tends to have a Lead ED attached, much of it is genuinely corporate on which EDs could be expected to have different views.

  4. Anonymous says:

    Paul Johnson says Anonymous t’is I

  5. Peter Reeves says:

    Paul, thank you for this. EDs normally do challenge each other – but outside board meetings, They have ample opportunity in management meetings, informally (as offices are usually close together) etc. But having agreed on a position through an executive discussion – which then goes to the board – most execs would then ‘back off’ somewhat for the reasons previously cited. Even if the CEO urged execs to challenge each other more in boards it would probably have little effect in most cases. Also, the CEO would risk appearing to have a ‘disunited’ exec team and would definitely not enjoy being directly challenged himself by another exec – especially if a similar challenge had already been made at an execs-only meeting that he had already strongly rebuffed!

  6. Anonymous says:

    Peter, apologies I think I forgot to scroll down the page these last few months… I have to confess always feeling on weak ground when exhorting EDs to wear their Board hat and not their Exec’s in meetings. I am entirely sympathetic to your views as to the CEO’s position, attitide and response. But I am not convinced that the NEDs can adequately challenge alone. It would be interesting to hear from Stuart’s Policy Governance colleagues: if the CEO is the sole line of command out from the board to the management team, does the same apply inwards? Does PG rely entirely on the NEDs for challenge?

  7. Anonymous says:

    Once again (Bah!) Anonymous is me. PJ, Parkhill

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