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High trust, robust challenge and a firm grip are key to success

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Failing NHS organisations get much more attention than successful ones, despite the fact that the latter far outnumber the former.

Significant time, although arguably not enough, is put into learning from those organisations that have delivered sub-standard care – but success is too often viewed with suspicion and ignored.

It is an unfortunate trait for the NHS to have developed and one found rarely in other sectors, where success stories are energetically picked over for lessons that can be copied.

So, spend some time reading Naomi Chambers and Alison Pryce’s analysis of successful NHS organisations – they have identified 19 star performers embracing both commissioners and providers – and the common characteristics of their boards.

They found the boards of the most successful organisations boasted “a climate of high trust coupled with robust challenge and a firm grip on the business”.

This lesson should be particularly heeded by clinical commissioning groups. With the Health Bill amended to increase the likelihood of CCGs having to hold public board meetings, starting off on the right foot will be key.

HSJ suggests CCGs pay particular attention to the need to appoint energetic non-executive directors. They need to find non-executives who understand their independent role (very different to representing a particular group), have the knowledge and experience to challenge executive members and are willing to ask difficult questions.

CCGs will also, of course, need to find money to pay non-executives – the best are unlikely to be cheap. Another strain on their management allowance and one more good reason why 200 CCGs makes more sense than the current 300-plus.

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