This is arguably the most challenging time that leaders in the NHS have ever faced and we know that the NHS will see much technologically driven change over the next decade and beyond.

“Big change” requires much more than just strong leadership and excellent project management, although both of these components are essential. We need to oxygenate people and teams to innovate and challenge current models. It requires bravery, wisdom and a willingness to break the mould in an environment in which everybody has become increasingly risk adverse.

Effective communication with a wide range of stakeholders and an ability to focus on the people rather than just the structures are critical to engagement and success. The indisputable fact is that, where the NHS is concerned, multiple minds from a broad range of backgrounds are better than one. Enter the role for a high performing non executive board.

There are many exceptional non-executive chairs and directors on NHS Boards who bring a diverse range of backgrounds gained from business, commerce, their professions and our public services. The sheer scale of the NHS with its 1.2 million employees in England and a budget in excess of £116bn with hundreds of separate organisations means that a non executive director can make a significant impact at various levels. As Chair of NHS Improvement, I would urge non executives to reflect and focus on the contribution they can make at this time of great challenge, but even greater opportunity, to reinvent our NHS for the 21st Century.

Non-Executives often have well grounded experience in different organisational and operational settings. They bring a different perspective and can contribute ‘constructive disruption’ and fuel improvement and innovation. They have an opportunity to challenge organisational culture and break down silos and barriers. They can shine an experienced light on knotty problems or help executive colleagues find the mental space to think differently about some of the toughest challenges.

The best non-executive chairs understand new landscapes for service delivery and look at ways to utilise the expertise of the non executive board to focus on people-at the heart of any change. Non-executives must provide energy for change to their health systems and can play a powerful role in mobilising partnerships and networks. Rather this than the dead hand of regulated governance which so often dominates the terms of reference of public service boards. Boards have a very real opportunity to promote collaboration and connect ideas with the capacity to work behind the scenes, influencing, enabling and mentoring.

If we can fully utilise this non executive expertise and energy alongside great and dedicated executive teams and in particular clinicians, we will deliver an NHS our public deserve and expect.

Ed Smith CBE

Ed Smith is the Chairman of NHS Improvement, lead non-executive director for the DfT, Pro-Chancellor and Chairman of Council at the University of Birmingham and a member of the CMA panel.



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