NHS Confederation: Media centre

Press release: Democratic deficit at the heart of the NHS

16 Jun 2005

The daily grind of internal operational issues and external national targets are stopping NHS boards from doing their job, finds a report published by the NHS Confederation today.

NHS boards have a broad range of legal duties, and, crucially, are charged with spending public money and looking after people's health and wellbeing.

Launched at the NHS Confederation annual conference, the report Effective Boards in the NHS? shows that boards are clear about their role of safeguarding patients' interests and championing local priorities.

But they find themselves bogged down in routine matters and the demands of targets, which prevent them from focusing on strategic planning.

And they are further hindered by poor quality information, no clear lines of accountability, and inadequate performance monitoring. A lack of trust and a culture that stifles debate add to the problems.

The report calls for several measures to improve the effectiveness and leadership capacity of NHS boards.
These include:

Greater focus on strategic issues
The fostering of a climate that encourages challenge
Clear lines of accountability
Investment in the training and development of board members
Regular evaluation of board performance

Gary Fereday, Policy Manager at the NHS Confederation said: 'Many boards recognise that they are not working as effectively as they need to, and some are already exploring ways of improving their processes and culture. But more needs to be done.

'The NHS Confederation is reviewing how it can support boards more effectively and work is ongoing into looking at how board performance can be properly assessed.'

Dame Gill Morgan, Chief Executive of the NHS Confederation, commented: 'Providing leadership in the NHS is increasingly demanding, and requires commitment and vision. The development of strong corporate boards is not an option for the NHS. It's a necessity.'

ENDS

Notes for editors

1. The NHS Confederation represents more than 90% of the organisations that make up the NHS throughout the UK. Its members include the majority of NHS trusts, foundation trusts, primary care trusts and health authorities in England; trusts and local health boards in Wales; NHS boards and special boards in Scotland; and health and social service trusts and boards in Northern Ireland.