Chairing an NHS Trust: Sue Musson’s OutsideIn Story

02 Jul 2020

Chairing an NHS Trust: Sue Musson’s OutsideIn Story

Sue Musson has nearly 25 years’ board-level experience in commercial and public sector organisations, helping them improve their strategy, performance and organisational cultures. She became Chair of Liverpool University Hospitals NHS Foundation Trust in 2019 having previously served as Chair of two other Trusts. She shares her experience of moving into healthcare.

Sue Musson

Life-saving introduction

Sue’s involvement with the NHS started in 2007, following her son’s recovery from a serious illness. When an advert appeared to join the Board of the NHS Trust that saved his life (Alder Hey Children’s Hospital) it appeared serendipitous.

Sue benefited at the start from a highly-supportive role model.

“I gained great experience in my first NED role working with an experienced Chair, who was very able and extremely encouraging.  She gave me opportunities to contribute and develop in the role.”

Sue was there during a great time as the organisation headed towards ‘foundation trust’ status and made progress in procuring a new hospital.

An evolving role and skills

Sue reflects that regulator expectations were very different in the early days of Foundation Trusts. At that time, the regulator was looking for non-executives from specific backgrounds who could bring financial insight, commercial experience and a demonstrably challenging approach.

It used to be that certain professions were sought for non-executive roles, but this is less the case now. “In reality, success is now very little to do with a title or profession and is more to do with having a philosophical connection to the values of the organisation and a willingness to apply knowledge, skills and experience to the goals of the trust. It is important to have a sense of how skills gained elsewhere translate usefully to the NHS environment.”

For example, Sue has appointed non-executives from companies such as BT, who have a CSR programme that encourages senior staff to join an NHS Board; they have been able to harness their skills as directors and have translated that well into the NHS.

“You need insight and empathy. Understanding efficiency and productivity is important, but morale, motivation and culture have a bigger impact on the patient experience and their outcomes at the end of the day.”

The role of the chair is very demanding. A Chair must create a positive Board culture that supports good governance and improvement. Credibility with stakeholders and regulators is vital, especially in the high-risk acute sector. Furthermore, a Chair must be empathetic and relatable to staff, personally driven by quality and the patient journey, and be able to work in the political realm. “Emotional intelligence is, therefore, an important dimension.”

Enjoying a great institution

Sue has certainly found her niche.

“I feel I am able to provide leadership in an organisation that makes a real difference to thousands of people – both staff and patients.”

“The NHS is our greatest institution by far, and I feel very privileged to be an NHS Chair. I am always motivated by hearing patient and staff stories; these remind me of the real impact our services have and how important it is that we listen, learn and strive to get it right every time.”

Any advice?

If you are considering a NED role, often the most able people are the most helpful, so - ask someone who has board experience to spare time for a coffee to ask questions and pick their brains.  Make sure you do your research and homework.

It is useful to observe a board meeting, though it’s important to note that the ultimate decision on appointments rests with the Council of Governors in a foundation trust.


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A word about diversity

“Gender balance has improved in the NHS, but there’s still work to do. Board ethnicity is also not reflective yet of the populations we serve. I look for diversity of thought as well. It’s important to welcome difference. I don’t want a board comprised of ‘me toos’, people who will just agree all the time.”

Sue’s final advice to candidates for NED positions is to make sure they also prepare themselves for disappointment and reconcile with the fact “you may not get the first one you go for.” As she says, “Treat it as a positive experience to learn more about the role and identify what would be a good fit for you.”

“Overall if you persevere, hopefully, you will find, like me, that it is a wonderful privilege to serve in an immensely rewarding role.”