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Found 85 results
  1. Content Article
    In this thought paper, Adrienne Fresko and Sue Rubenstein look at patient safety advice for boards from recently published guidance and research. 
  2. Content Article
    This paper was presented to the NHS England board at its public session on 16 May 2024. It discusses the effect the pandemic has had on NHS productivity with details of NHS England’s estimates for the drivers of the loss of productivity observed. It also discusses the emerging plan to improve productivity in the coming years.
  3. Content Article
    In this HSJ blog, Ken Jarrold highlights three key things he learned during his ten years as chair of NHS trusts: Focus on the people that matter—service users and frontline staff Keep an appropriate level of contact and relationship with the chief executive Live the values of the trust. He emphasises chairs keeping their focus on the people they serve and ensuring they feel at home interacting with staff and service users, as well as other leaders. He also states his hope that the Leadership Competency Framework for conducting annual appraisals of NHS chairs published by NHS England in February 2024, if applied appropriately, will result in improvements in how chairs serve their organisations.
  4. Content Article
    This framework establishes a standardised approach to the annual appraisal of chairs, including ICB, NHS trust and foundation trust chairs. The appraisal should be a valuable and valued undertaking that provides an honest and objective assessment of a chair’s impact and effectiveness, while enabling potential support and development needs to be recognised and fully considered. The framework is aligned with the NHS Leadership Competency Framework and informed by multi-source feedback. It establishes a standard process, consisting of four key stages, to be applied to the annual appraisal of chairs.
  5. Content Article
    Integrated Care Boards (ICBs) are responsible for commissioning and funding care provided by the various healthcare providers in its area, such as hospital trusts and community trusts. This blog offers patients practical advice on how to hold their ICB to account, for example, by raising questions at their ICB's monthly or bimonthly meeting.
  6. Content Article
    This practical guide from NHS Providers aims to support NHS trust board members to address health inequalities as part of their core business. It outlines why trusts should act on health inequalities, includes a vision for what good looks like, a self-assessment tool for trusts to use to determine where they are in their journey and a list of suggested objectives for board members. It covers a wide range of trust work, from operational and clinical delivery of services, to the trust’s role as an anchor institution and as an employer of NHS staff. The suggested objectives are drawn from NHS England (NHSE) policy, guidance, and good practice from the sector.
  7. Content Article
    This article by the Patient Experience Library summarises the findings of an independent review of services at University Hospitals Sussex Trust by the Royal College of Surgeons. The article highlights that it is a positive sign to see the Trust publishing a sensitive report publicly, noting that in the past other trusts have suppressed reviews of this kind. The review highlighted some concerning findings, including: A high volume of complaints from patients and delays in responding. Consultant surgeons being dismissive and disrespectful towards other members of staff and displaying hierarchical behaviours towards allied healthcare professionals, particularly junior members of staff. Reports of two trainees being physically assaulted by a consultant surgeon in theatre during surgery. A culture of fear amongst staff when it came to the executive leadership team, with instances of confrontational meetings where consultant surgeons were told to 'sit down, shut up and listen'.
  8. Event
    The overall objective of this masterclass is to build good governance commitment, capacity, and resilience in the face of severe resource constraints and complex staff, patient, political and regulatory expectations. The programme is interactive, developmental, based on best practice and focused on achievable improvement of practice, behaviours and outcomes. The course includes online access to the relevant CQG e-learning module for 12 months and a discount code to purchase additional modules. This masterclass is one of a series that will help enhance your understanding and application of governance in healthcare, this module recognises the mechanisms and drivers for improvement available to the board, including creating a culture for effective analysis and reporting of outcome measures and benchmarking internally. We clarify the role of the board in organisational scrutiny and challenge. We also look at the ways the board can add value and ensure exemplar organisational effectiveness by developing its own culture of improvement. Each masterclass has its own set of learning objectives, the final one of each is to be able to apply the learning to the participant’s own organisation using the provided CQG Maturity Matrix. The matrix can be used to set strategic objectives and consider progress over coming months. At the completion of this module, the participants will be able to: • Understand the mechanisms and drivers for improvement available to the board. • Clarify the role of board scrutiny and challenge. • Assist the board in adding value and ensuring organisational effectiveness by developing its own culture of improvement. • Apply the learning to the participant’s own organisation using the CQG Maturity Matrix. Register
  9. News Article
    A board director has publicly criticised his trust for its treatment of Muslim staff and patients. Mohammed Hussain posted on social media that some board members at Bradford Teaching Hospitals “are not heard and listened to”, and that there is a “dissonance” between its espoused values and the “lived experiences” of minority ethnic staff. Mr Hussain, a non-executive director since 2019, was responding to a post by CEO Mel Pickup, who had said the trust had a “variety of support offers for colleagues observing Ramadan”. He said there are “many examples” of Muslim families experiencing poor responses to complaints to the trust, while claiming that “outstanding” Muslim staff are having to “move out of the area to progress because they are not promoted internally”. The trust said its launching an investigation into the concerns raised by Mr Hussain. Read full story (paywalled) Source: HSJ, 12 March 2024
  10. Content Article
    A framework for boards and an example of what has worked in practice.
  11. Content Article
    The audit committee handbook reflects developing best practice in governance.
  12. News Article
    NHS board members must speak up against discrimination, challenge others constructively and help foster a safe culture, under a new NHS England assessment framework. The new leadership competency framework, published today, sets out six domains which board members are required to assess themselves against as part of an annual “fitness” appraisal. Each domain (see below) contains competencies directors must exhibit, such as: Speak up against any form of racism, discrimination, bullying, aggression, sexual misconduct or violence, even when [they] might be the only voice; Challenge constructively, speaking up when [they] see actions and behaviours which are inappropriate and lead to staff or people using services feeling unsafe, or staff or people being excluded in any way or treated unfairly; and Ensure there is a safe culture of speaking up for [their] workforce. Each competency statement gives board members a multiple choice to assess themselves against, ranging from “almost always” to “no chance to demonstrate”. Organisations have been told to incorporate the six competency domains into role descriptions from 1 April, and use them as part of board member appraisals. Read full story (paywalled) Source: HSJ, 28 February 2024
  13. Content Article
    This framework is for chairs, chief executives and all board members in NHS systems and providers, as well as serving as a guide for aspiring leaders of the future. It is designed to: support the appointment of diverse, skilled and proficient leaders support the delivery of high-quality, equitable care and the best outcomes for patients, service users, communities and our workforce help organisations to develop and appraise all board members support individual board members to self-assess against the six competency domains and identify development needs.
  14. News Article
    An NHS trust has concluded that its former chief executive is not a “fit and proper person” to be on an NHS board, after investigating allegations of sexual harassment and inappropriate behaviour, HSJ has learned. HSJ understands The Robert Jones and Agnes Hunt (RJAH) Orthopaedic Hospital Foundation Trust commissioned a specialist external workplace investigation into Mark Brandreth, which considered serious allegations made about his behaviour during his time as trust chief executive between April 2016 and August 2021. Mr Brandreth is understood to dispute the allegations as well as the investigation’s findings, and is seeking to challenge RJAH’s handling of the complaints and its process for deciding he did not meet the Fit and Proper Person Test. Sources with knowledge of the situation said almost 30 female RJAH staff members came forward to give information to the investigation, but it focused on 12 employees who were willing to give evidence. HSJ has been told that as a result of the investigation, which concluded at the end of last year, the trust’s chair has informed NHSE in writing that it believes Mr Brandreth does not meet the “Fit and Proper Person Test”, implying he should be ruled out of board roles – or roles with equivalent responsibility – at English NHS organisations and adult social care providers. However, the trust, in Shropshire, is not planning to publish its ruling and – with no professional regulation in place for health and care managers and/or board members – it is unclear how effective the conclusion will be if it is not made public. A female staff member told HSJ of her concerns that “nothing is being done”. Read full story (paywalled) Source: HSJ, 21 February 2024
  15. Content Article
    The role of the board is critical in ensuring that high quality patient outcomes are first and foremost in an organisation’s culture. Health care organisations should capitalise on the expertise of their board, applying their knowledge to guide improvement in organisational performance. For board members to be effective, they need the knowledge, information and guidance on board processes that support quality and safety. By providing resources and education on best practice processes, boards can successfully impact efforts to improve quality and patient safety across the world.
  16. Content Article
    Joint Commission Resources (JCR) has created the Board Education Resource Center: a collection of complimentary resources to give boards and executive teams the vital support and education they need to best serve their organisations and communities.
  17. Content Article
    Recurring problems with patient safety have led to a growing interest in helping hospitals’ governing bodies provide more effective oversight of the quality and safety of their services. National directives and initiatives emphasize the importance of action by boards, but the empirical basis for informing effective hospital board oversight has yet to receive full and careful review. This article presents a narrative review of empirical research to inform the debate about hospital boards’ oversight of quality and patient safety.
  18. Content Article
    In this BMJ Leader article, Roger Kline discusses the failings of the Countess of Chester NHS Boards in 2022 following the arrest of Lucy Letby. Roger highlights that this is not unique to the Counter of Chester: Reputation management that avoids timely decisive action is familiar to staff in many NHS organisations. Primacy of finance at a time of gross NHS under-resourcing has roots in Government policy and a national failure to challenge it. The failure of the Countess of Chester Board to be curious and create a culture where staff who raised concerns were seen as “gold dust” not troublemakers, is commonplace not unique. Roger acknowledges that there are no simple solutions but says that the regulation for managers is a performative gesture unless accompanied by other measures. He suggests that we "Make patient safety the prime litmus test for all initiatives and 'stop the line' (from Board to ward) when it is not. Do not allow organisational reputation to ever influence decision making in response to concerns. Be relentlessly 'problem sensing' not “comforting seeking'”.
  19. Content Article
    Boards and leaders of healthcare organisations are legally responsible for the performance of their organisation and must take definitive responsibility for improvements, successful delivery and failures in the quality of care. Board effectiveness relies on the ways in which board members translate their knowledge and information into quality and safety plans with measurable goals, maintain oversight on progress towards these goals and hold the chief executive accountable for these goals. This resource by the Canadian Patient Safety Institute lists tools available to boards and board members to allow them to understand their legislative responsibilities for quality and safety, conduct self-evaluation and understand the competencies needed to lead on quality and patient safety.
  20. Content Article
    Patient care inevitably raises issues of safety. Safety measures can never be failsafe, but they can always be improved. The aim of this publication is to offer guidance to boards on helping to bring about these improvements. The publication was developed by Monitor for NHS foundation trusts, though its principles apply equally to other NHS settings. It draws on evidence and best practices from UK pilot sites, and also taps the experience of healthcare providers in other developed countries who use similar principles and approaches. The field research and work with the UK pilot sites took place between October 2009 and March 2010.
  21. Event
    In this webinar hosted by NHS Providers, attendees will: learn about the different models of co-production with communities and how these could be applied to the work at your trust hear about the value of working with underserved communities to understand their experiences accessing healthcare services and how this can contribute to the wider agenda of reducing health inequalities discuss with others the enablers and blockers that trusts face when seeking to engage with communities in their service design and development. This webinar is open to NHS board members and health inequalities leads from trusts, foundation trusts and ICBs. Confirmed panel Louise Ansari – chief executive, Healthwatch England Keymn Whervin – head of experience, National Voices Sarah Balchin – director of community engagement and experience, NHS Solent Book a place at the webinar
  22. News Article
    Doctors at a Black Country mental health trust have backed a vote of no confidence in their management team. Sources say that the Black Country Healthcare NHS Trust is not acting in the best interests of patients and they believe it wants to cut beds. They also have no confidence in the way that the trust has removed its chief medical officer, Mark Weaver. The NHS Trust said it was aware of concerns and had agreed to work on them going forward. The doctors wrote to the trust board following a meeting of the Medical Advisory Committee claiming that over the past two years the relationship with the board had become fractured. In the letter they claimed the voice of doctors was not being taken seriously by the board and that clinical priorities were secondary to financial performance. They also said they were seriously disturbed with the way in which Mr Weaver had been asked to step down and that the deputy chief medical officer Dr Sharada Abilash had not been asked to take over while due process occurred. Read full story Source: BBC News, 9 December 2023
  23. Content Article
    Professor Jane Somerville, emeritus professor of cardiology at Imperial College, talks about the issues facing doctors who raise concerns about patient safety issues in the NHS. She shares her views on the risks facing doctors who speak up and the ways that healthcare managers treat whistle blowers. She also highlights issues in the employment tribunal system and outlines the need to regulate NHS managers. In the video, Jane mentions the employment tribunal of Dr Martyn Pitman. Since this interview was recorded, Dr Pitman lost the case he brought for retaliatory victimisation.
  24. News Article
    A report highlights that maternity and neonatal services are often regular agenda items at board meetings, but the quality and quantity of information that is presented and the subsequent discussion (or lack thereof) doesn’t lead to effective oversight. The shocking and distressing stories emerging from the Lucy Letby case in August 2023 shone a light on the “cover-up culture” in the NHS. Although deliberate harming of babies is thankfully exceedingly rare, some of the issues raised in this case echo concerns that trusts are failing to react to signs of poor performance in maternity and neonatal services. Responsibility ultimately lies with trust boards which have a statutory duty to ensure the safety of care. However, the actions (or inactions) of leadership have come up frequently in inquiries and reviews. Read full story (paywalled) Source: HSJ, 7 November 2023
  25. Content Article
    Trust boards’ regular oversight of the quality and safety of maternity and neonatal services has been the subject of successive inquiries and reviews. In this report, the Sands and Tommy’s Joint Policy Unit review publicly available board papers and minutes for seven NHS Trusts in England. They analyse whether the information presented to boards, the process for review, and actions taken enabled boards to deliver effective oversight over the safety and quality of maternity and neonatal services.
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