Strengthening NHS board diversity (NHS Confederation, 15 June 2021)

Summary

Chairs and non-executives are an important NHS leadership group. As independent board members, they hold the executive to account and in doing so build patient, public and stakeholder confidence in the NHS. This report by the Independent Taskforce on Improving Non-Executive Director Diversity in the NHS explores the steps needed to strengthen the diversity of NHS boards in England.

Read a shorter summary of the report

Content

Key points

• A 2019 NHS Confederation report found that there was insufficient diversity in those appointed to these roles in the NHS.
• A more equal and diverse leadership among chairs and non-executives will mean patients, communities and staff will have leadership that is more reflective and sensitive of the communities the NHS serves. Such a diversification is more likely to transform culture for the benefit of patients and champion patient and staff engagement.
• An independent taskforce commissioned to review how to strengthen NHS board diversity has found that the NHS appointments process is not independent or transparent; diversity in NHS board roles is often hampered by the rigid candidate criteria; NHS roles are often considered to be unattractive to candidates from underrepresented groups; ‘chemistry and fit’ tend to override diversity, which results in ‘more of the same’; commitments from the top are among important vehicles for change.
• If NHS organisations are to create a sustainable pipeline of chairs and non-executives that reflect the staff and communities they serve, current non-standard appointment processes need to be refreshed and be independent. The taskforce has put forward a set of recommendations to support a step change in the composition of NHS boards.
• Measures include establishing an independent appointment process; setting up a confidential feedback mechanism for NED candidates to raise concerns about a recruitment process; publishing data on the protected characteristics of those who applied, are longlisted, shortlisted, interviewed and are appointed; negotiating a compact with executive search firms; and ensuring succession planning arrangements are in place for replacing an organisation’s chair and non-executives.
• The move to system working and putting integrated care systems on a statutory footing provides an opportunity for the NHS to reset, change the appointments process and appoint diverse leaders. Integrated care systems will have new responsibilities and accountabilities across the system and the NHS organisations that sit within their remit.