Why it could make sense to consider a non executive role

The NHS is changing, and at an unprecedented rate. With 0 per cent growth forecast in the coming years and an ever more demanding and ageing population to cater for, the system is under immense pressure to deliver better care, and to do it faster and cheaper. In anybody’s book this is a difficult equation to balance and one that has pushed the NHS into media headlines on a daily basis.

Times are already very tough and set to get tougher. The public and political profile of the sector has never been higher. Regulation is on the increase. And continuous change and cost saving is very much the name of the game. So why would you consider becoming a non executive director of an NHS board?

Actually there are three very good reasons why you should consider it:

• The expertise and experience you have acquired in the commercial, voluntary or wider public sectors could be highly relevant to the NHS environment;
• We all have opinions on how the NHS should be run; as a board member you’ll no longer just be watching from the sidelines;
• Sitting on the main board of an organisation that controls a budget of between £50m and £2bn will look pretty good on your CV.

Do you have what it takes?

If you have your sights set on getting your first NHS non executive position, what skills do you need to make the transition work? First and foremost you need to understand what the role of the non executive director actually is – if you expect to be handed the reins of a £200m hospital or asked to lead a 20 per cent cost improvement programme, you will get very frustrated, very quickly. And if you don’t, your chief executive certainly will. But if you are expecting to make a high level contribution to the development of corporate strategy and to constructively challenge, support and when appropriate, mentor members of the executive, then the role is likely to prove a much more fulfilling experience.

Operating on the board of an NHS organisation requires a level of political antennae rarely seen in other sectors. The stakeholder networks within which you operate are vast and might include patient groups, members of the general public, staff groups, elected governors, the media, MPs, regulators, local government councillors and of course clinicians. Many of your board meetings might be open to the public and given the tough and potentially unpalatable decisions NHS bodies now have to take, the way in which you and your colleagues handle these messages could mean the difference between success and failure.

Non executive directors need to offer challenge in the board environment, both as a tool to ensure probity and accountability, as well as to support the continued growth of the executive team. Knowing what questions to ask, and when and how to ask them is a crucial skill and not one that all senior leaders possess. Equally, being able to respond to challenge, overcome resistance and gain buy-in to ideas are all central to ‘holding your own’ in the boardroom.

The personal qualities sought in non executive board members are underpinned by the Seven Principles of Public Life, also known as the Nolan Principles: selflessness; integrity; objectivity; accountability; openness; honesty; and leadership. More information can be found at www.public-standards.org.uk

Your professional background

Breadth of experience and expertise is hugely important in any non executive director. However there are some specific functional areas sought by NHS organisations in recognition of where the challenges and the scope for improvement and innovation lie moving forward.

These include: finance/audit; turnaround; marketing and customer engagement; HR and OD; commercial development; legal; diversity and equality; property management and capital programmes; IT and information management.

Commercial sector experience is no less or more valuable than voluntary or wider public sector experience. However having operated within large, complex, customer driven organisations is essential. The NHS is about providing safe, effective and timely services whilst keeping costs low and value for money high. A number of other sectors share this aim and hit the headlines almost as regularly as the NHS, such as public transport, social care, financial services and utilities. Therefore, you should think less about what expertise you can offer and more about how transferable it can be into the modern NHS environment.

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