Updated: Board Development Tool for Foundation Trusts and Aspiring FTs Building on the existing work that has been undertaken with the NHS Institute’s Board Development Tool (‘BDT’), the Board Development team has recently developed a version of the tool for Foundation Trusts, featuring a new Board Effectiveness Model. The BDT has been used by more than 300 organisations and its aim is to provide a framework for reviewing and improving NHS board performance. What the measures: Board Development Tool The BDT helps Boards to review their effectiveness, and is intended to be completed by all members of the Board of Directors, both Executive Directors and Non-Executive Directors. The Board Effectiveness Model is based on good practice known to contribute to board effectiveness. The model describes three roles core to any highly effective board: 1. gaining insight and foresight 2. clarifying priorities and defining expectations; and 3. holding to account and seeking assurance. . A board’s ability to perform these roles depends on the effectiveness of various ‘enablers’ as shown in the outer circle of the Board Effectiveness Model diagram. These enablers can be inputs, processes, systems, structures or behaviours. For example, a Board could not perform its gaining insight role without receiving intelligent information and having a Board comprised of people that understood that information. The tool also enables boards to take an external perspective seeking the perceptions of wider stakeholders. Stakeholder engagement is agreed with the organisation: The Board Effectiveness Model Board Members Key Stakeholders: Staff, Governors, Patients Wider system stakeholders The NHS Institute BDT has been used by more than 300 NHS organisations. The content of the new BDT diagnostic was developed in consultation with a range of stakeholders. Leaflet v. 4.11 Updated: Board Development Tool for Foundation Trusts and Aspiring FTs The process 1. Undertaking a consultation and set up meeting with the Chair and CEO (2 hrs) 2. Administering the on-line Board Development Tool to all Board members and a version of the tool to governors (30% of) and staff (5% of, comprising frontline clinical staff, middle and senior management) 3. Interviews with each member of the board to ascertain their views on the effectiveness of the board and their experience of using the tool (1hr) 4. Observe one board meeting (1 day) 5. **Undertake focus groups to ascertain Governors’ and Staff perceptions of the effectiveness of the board (approx 2 hrs each). Participants do not have to be those whose have completed the questionnaire 6. **Interviews with key and wider organisational stakeholders 7. Feedback the themes from the review to the Chair and CEO in the first instance (2 hrs) 8. Facilitate a whole board workshop where we share the themes and collectively agree actions (3hrs) 9. Follow up workshop three months post feedback (3 hours) **We recommend undertaking steps 5 and 6, however these are optional. Additional workshops and support are also available post BDT activity. The NHS Institute BDT has been used by more than 300 NHS organisations. The content of the new BDT diagnostic was developed in consultation with a range of stakeholders. Leaflet v. 4.11 Updated: Board Development Tool for Foundation Trusts and Aspiring FTs Board experiences after undertaking the Board Development Tool: Raised awareness of Stakeholder Engagement After undertaking the BDT, one Trust’s board has worked on patient and public engagement, using focus groups with Citizens’ Panels to consider how best to develop services; and Board to Board meetings between the PCT, Acute Trust, Mental Health Trust and Local Authority to extend partnership working. Clinical Involvement After undertaking the BDT, one Trust’s board has set up a Clinical Senate, which will be involved in decision-making. Made up of clinical representatives from across the health economy, this Senate allows for proper clinical engagement, and will promote a cohesive, unifying clinical force in the Trust’s region for future development. The Executive/NED divide Teamwork and board dynamics From ‘grumpy’ and ‘old style’ NHS attitudes, one Trust has changed meetings to ensure constructive, appropriate challenges, the presentation of higher quality information, and an efficient, structured agenda. The result is more productive debate, an awareness by individual members of the effect of their behaviour on others. “There has been a demonstrable change – challenge has been far more controlled, it’s less emotive and more focused on business.” The board introduced a buddying system, pairing Executive Directors and NEDs. They meet regularly, familiarizing NEDs with the Executives’ work, enabling constructive challenge, enhancing trust, promoting shared understanding of the agenda and vision. NED workload To address workload issues, Trust Associates now take on tasks such as sitting on the Pharmaceuticals Approval Committee. This allows NEDs and the board to focus on monitoring performance and engaging in strategy development. The NHS Institute BDT has been used by more than 300 NHS organisations. The content of the new BDT diagnostic was developed in consultation with a range of stakeholders. Leaflet v. 4.11 Updated: Board Development Tool for Foundation Trusts and Aspiring FTs Outcomes include actions at a number of levels: Strategic Actions: Work on strategy; review the role of the Board and its members as a governing board; improved awareness and influence with wider key stakeholders; support Board development as part of progression to FT status; development of an OD plan Operational Actions: Improving information presented to the Board; revising the operations of the board; board agenda and use of board time; and level and appropriateness of challenge Interpersonal Actions: Structural changes to personnel on the board; work on relationships between board members; personal development for board members; finding additional opportunities to spend time together Wider Actions: Partnership working; visits to other boards How long does it take? Our experience shows that this is usually a ten to twelve week process, but this can be adjusted to meet your needs, and is followed up by a workshop three months later as required. Contact details For more information about the BDT and the support we can provide please contact [email protected]. View our products and services at http://www.institute.nhs.uk/boarddevelopment The NHS Institute BDT has been used by more than 300 NHS organisations. The content of the new BDT diagnostic was developed in consultation with a range of stakeholders. Leaflet v. 4.11
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