If I were asked to describe the role of non-executive directors in the NHS succinctly, I could do it in two words - local champions.
Good NEDs must stand up for their local NHS. We must be the driving force that puts ambition into our organisations, energising our people on behalf of our patients. We must be champions for our patients, our public and our staff.
Ambition should be the driving force of all organisations, whether private or public sector, and the NHS in particular. Organisations that just do the day job and never look to the future will atrophy.
A board's job is not simply to ensure that national targets are met and that finances remain on an even keel, as important as that is. We should achieve national targets, recognising they are the minimum requirement and then turning them into ambitious local targets.
We did this in the East of England. We spent the last two years driving financial efficiency across the NHS, seeking to get rid of the£230m debt we had inherited from our three predecessor strategic health authorities. It was a task that required leadership from the top, but also in every organisation in the region.
Now, two years later, the debt is paid off and we will be in surplus this year. And on the subject of the surplus, we must get the narrative right: in the East of England, our surplus for 2007-08 will be around£90m, a figure that represents a mere four days of NHS activity.
We recognise that patients, the public and staff need to see the benefits of this financial turnaround. They need to see this year's surplus as a benefit to be spent on their behalf, not an underspend to feel short-changed about.
That is why we showed ambition, driven by the SHA board but bought into and carried forward by all 41 NHS organisations in the region. We set out a clear vision for our NHS - to be the best in England - and supported this with 11 specific and measurable pledges. It is called Improving Lives, Saving Lives and we now mould our board meetings around progressing these pledges, in public.
Last year, we consulted staff, patients and the public throughout the region on these changes. They were accepted and now they are what our NHS will do, what we will be judged against, what the public can expect from us.
Our plans cover three areas: delivering a better patient experience, improving people's health and reducing unfairness in health. The pledges range from increasing waiting time guarantees to areas that do not currently benefit from them to guaranteeing access to local primary NHS dental services for all who need them.
They cover a commitment to become the safest health service in England and a target of reducing the life expectancy differences between our poorest and most prosperous communities.
This is action. We asked our public and staff what was wrong with our local NHS, what they would like to see get better, and then promised to make the changes they wanted.
This is non-executive leadership standing up for our patients, public and staff; driving ambition through our organisations; and then ensuring we can and will be held accountable for delivery.
I have sat in meetings in my role as chairman of a strategic health authority and seen chief executives and other executive members taking flak while the chairman sits passively, abdicating responsibility. This is not good enough. The first question I ask of the chairman is: "What is the board doing about it?" The chairman and the rest of the board cannot hide behind their full-time directors.
If we are not adding value, if we are not getting the big picture, if we are not showing leadership and support to our people, then we are failing and we should go. If we are driving ambition, then we are doing a job to be proud of - one that I, for one, love.