Lawyers – A Great Fit For NHS Boards
We were delighted to welcome Laura Carstensen and Janice Scanlan to our BCKR Breakfast Event this week to discuss the value of joining an NHS Trust and how you might go about it.
Laura’s wide ranging portfolio includes being a non-executive director of NHS Improvement where she sits on the committee with responsibility for trust leadership, directly appointing to NHS Trusts and influencing the role in Foundation Trusts. She works closely with Janice who heads NHS Non-Executive Development.
Laura was a partner at Slaughter and May until 2004, when she began her portfolio career, successfully combining business and public service roles. She currently chairs AIM listed Park Group and is a NED on the Co-op Bank board. Laura has also been deputy chair of the Competition Commission and a Commissioner for Equality and Human Rights.
Here is a summary of what they had to say:
Why join an NHS board?
• You will find it really rewarding
• You are doing something worthwhile
• It is the definition of public service
• You will learn a lot about boards, non-exec behaviours, committees etc.
A lot of us will have had direct personal experience with the NHS and will therefore feel passionate about it.
Lawyers are seen more positively in the NHS board context. Why:
Because governance is a hot topic in the NHS and lawyers are good at identifying risk, ensuring decisions are made, looking at detail, pulling out the salient details from large documents, asking pertinent questions and are confident asking challenging questions.
Their skills are very transferable in this highly regulated environment. They are skilled at ensuring compliance without stifling.
As a general observation, it is an often unrecognised skill of lawyers that they work well in crises and difficult situations (because it is an inherent aspect of the day job). It is a useful attitude for some aspects of board life.
Laura’s original route into the NHS was through her interest in regulation. While she was at the Competition and Markets Authority, she joined the board of Chester Hospital – her local hospital in Manchester – and it led to a change in her view completely. She began with a pro competition/regulation attitude, but, sitting on that board made her realise the weight of regulation made it very difficult for the board to have a strategic approach.
Laura later joined the board of NHS Improvement, an organisation which helps hospitals to reach their 5-year review targets by assisting in the appointment of board members to their boards and creating a talent pool to help boards deliver improved performance.
Laura is now passionately for de-regulation and cooperation between NHS entities – now the core of the NHS approach.
Janice is head of non-executive development at NHS Improvement. She said the good news is that there is plenty of opportunity for potential NEDs within the NHS – with 233 local secondary health care providers across England across a range which includes very large Trusts like Barts Health NHS Trust and much smaller Trusts like Tavistock and Portman NHS Foundation Trust.
If you are looking to join the board of an NHS Trust identify an area you feel passionate about whether that is a general hospital or a more specialist entity such as a Mental Health Trust, Ambulance Trust etc.
The benefits of taking a non-exec role on an NHS board are:
• That you will be giving something back
• It is a vitally important public service
• Where else can you get access to that range of roles
• You get exposure to different leadership styles
• It is a great opportunity to use your skills in a new environment
• It is a good way to raise your personal profile and increase your personal network as you will sit on boards with the business community (who also sit as NEDs) as well as a wide range of people in your local community
What does NHS Improvement do?
• It is a one stop shop for people wanting to get involved in NED roles in the NHS
• They keep a talent pool of interested people
• They have a mailing list of roles that you can be added to
• They recognise that not everyone comes ‘board ready’ and have set up NeXT Director – a scheme established to help find and support the next generation of talented people (although this is largely aimed at aspiring NEDs from BAME communities
Janice would be very happy to have a conversation with any member who might be interested in pursuing a role on an NHS board. She is happy to look at CVs and supporting statements in the application process, and to facilitate personal introductions to the Chair of a particular trust which you might be interested in.
The application process.
It does not involve the full blown public sector process. The primary focus for Chairs is to see that you are committed and to understand your motivation.
How different is an NHS board to a Board in other Not for Profit/Corporate sectors?
In essence, it is relatively similar in operation. It does have its own language, which can be a barrier initially, but you would become accustomed to that within a couple of board meetings.
Like any organisation it has its own culture. Though it has a reputation, on a frontline level, for problems of bullying behaviours, Laura has never seen that and in fact has only seen people bending over backwards to get things done.
How much autonomy will a board have?
If the Trust is ticking along with no particular issue – then the Board will be relatively free to operate.
If, on the other hand, you are a Trust in special measures then NHS Improvement will be significantly involved. A representative might sit in on board meetings (distinct from being on the board). But their aim is to help and support the board to resolve their issues and improve their ability to deliver.
People worry about personal liability and reputational damage. What sensible due diligence should you undertake before taking a role on an NHS Trust board?
All board rooms are or course becoming more high profile – you should accept that. Of course, the NHS is different when it comes to clinical errors which evoke very strong public reactions. However, the boards are very transparent.
Make sure you have frank discussions with the Chair, Chair of Audit and Medical Director before taking on a role.
One of a lawyer’s skills is that they work well in a crisis!
If you are seriously interested in joining an NHS board start networking in that world then the NeXT Director scheme is a good start. You should also:
• Talk to people who already sit on a board and
• Attend a board meeting – as NHS Trust board meetings are open to the public
What is the average time commitment?
Advertised generally at 2.5 days per month which includes reading papers and attending a board and perhaps committee meeting.
The board meetings are quite often during office hours. Improvement is encouraging boards to change that approach and be more flexible.
You do get paid a small sum as a member of an NHS Trust:
• £10-15,000 pa for a Foundation Trust, and
• £6,000 pa for an NHS Trust