Board Priorities through and beyond the pandemic: insights from non-executive NHS leaders

Clarity of Purpose, Pace

In the past weeks, NHS colleagues have shown huge agility which has re-framed previous working practices. Changes to service provision and operating models have been made quickly, benefiting from a lighter regulatory regime and the removal of bureaucracy. Clarity around purpose and pace has been energising for colleagues, and particularly empowering for executive leaders, creating a refreshed culture of mutual support.

  • How do we retain this energy, clarity of purpose and pace as complexity re-emerges in the next phase and we move back from command and control?

Inequalities and Diversity in our Communities, Full Mix of Services

The response to, and impact of, Covid-19 has further exposed existing inequalities and re-emphasised the importance of representative leadership to provide more effective care for our communities. Our discussion also acknowledged the importance of care and support for NHS staff is crucial at all levels, in mental health provision, against a backdrop of ongoing fluctuating crisis.

  • How do we ensure leadership teams have the connections with and understanding of all parts of the communities they serve to ensure effective planning and communication? How do we hear patient voices?
  • There has been a strong focus on the acute and emergency sectors in the crisis. How should providers work together to ensure the highest quality care across communities as the response now shifts to community services, mental health providers and primary care?

Digital transformation

Technology has been a great facilitator, in the delivery of care, with consultations taking place remotely, and in bringing together boards and system leaders flexibly. Our discussion acknowledged It is important to recognise that technology and social media can be exclusionary for some parts of the community, not universally trusted, and in some cases exploited with malicious intent.

  • How will we ensure the possibilities of digital transformation are part of an ongoing strategic-level conversation?

Prevention, Population Health, System working

The pandemic has shone a light on the importance of prevention and early intervention and the role that providers can play in both. Throughout our discussion, the idea of improved system working, and better collaboration between providers and other parts of the system, and between different sorts of services, was implicitly and explicitly seen as a positive to celebrate, and a stepping stone to consolidate for the future. A population health approach will require it. Relationships with local government, and its preparedness, are also critical.

  • How should providers support prevention, and better health and wellbeing in their communities?
  • Relationships as strategy: how will boards need to think about their partners and collaborative work to consolidate recent successes and move forward?

Dynamic risk

The new appreciation of dynamic risk leaves questions about how governance should look in future: how much has really been lost in the new governance model? There is an opportunity to reset governance practices, and boards’ strategic orientation, but governance will always need to be strong and appropriate.

  • How should boards think about risk, strategically and dynamically, in a framework of good governance?

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