GOVERNANCE Appointments chief brands trust boards a 'disaster'

Published: 26/05/2005, Volume II5, No. 5957 Page 6

The chief executive of the NHS Appointments Commission has launched a stinging attack on trusts' committee culture, which he branded a 'disaster'.

Roger Moore told delegates at an HSJ corporate governance conference that trust boards needed to cut down on the number of committees if they hoped to be efficient organisations.

'Too many committees are actually a disaster; they shed responsibility from the board, ' he said.

'There is a strong suggestion that the audit committee should be the only committee and it should cover remuneration and take over risk management and clinical governance.' Mr Moore said the type of committees he detested most were those that existed to enable 'non-executive teams to keep a handle on what is going on, compensating for a lack of trust and organisation'.

'Lots of boards do not have a clue as to what is going to happen next; there are too many strands, ' he said. 'Organisations can't govern in this way... trust boards need to bring the strands together in an integrated way up front.' Mr Moore said primary care trust boards would have to be 'quite ruthless' if they are to succeed under payment by results and 'ensure enough muscle to counteract the flat-out commercial approach to life [of foundation trusts]'.

Paul Stanton, director of the board development team, part of the NHS Clinical Governance Support Team, warned that the scale of demands placed on board members was 'disproportionate to capacity not capability'.

He told delegates that 'tribalism' was alive and well in the NHS and that there needed to be much greater devolution to the front line.

Birmingham and Solihull Mental Health trust chair Dr Jonathan Shapiro cautioned that non-executive directors were either not being used appropriately or being underused.

He said that non-executives had a key role to play in holding trusts to account but they should be willing to risk removal by standing up to policies they believed would harm their organisations in a way that managers would not because of the potential risks to their careers.

'We can and should be the fuse in the circuit but I am not sure that this is happening, ' he said.