Many will be familiar with the often-described roles of boards around strategy, accountability and culture setting within their organisation but we mustn’t forget a key component around instilling confidence in the organisation both as a place to work and also as a place to receive care and support. An inclusive and representative board has to be a prime component of that confidence building, writes Ifti Majid, chief executive at Derbyshire Healthcare NHS Foundation Trust and co-chair of the BME Leadership Network.
I recently had the privilege to attend a ‘faith tour’ within the City of Derby run by a local charity, a must for all senior leaders. Chatting to the local faith and community leaders two things became very clear to me.
Firstly, being representative at a board level is only the tip of the iceberg, actually being part of local communities, being known and recognised by local communities is the real prize in instilling confidence in an organisation.
Secondly, we talk glibly about this panacea of having a representative board but then what? Talking to vibrant local communities made it clear to me that having a culture as a board that actively seeks out difference, looks for alternative views, and uses diversity to challenge established NHS norms is essential if we are to really take steps to increase our communities confidence in us. It’s not diversity per se but how we use it that counts!
I have always had a healthy scepticism about target setting for boards around diversity that perhaps was driven by an idealistic and maybe naïve belief that as boards we should instinctively do the right thing – three years into my tenure as CEO and I am now a strong advocate of target setting.
Why? Well, we know that when we measure performance we generally improve, it is important to give formal recognition to the clinical benefits of board diversity and we need to give a lever to our workforce and our communities to hold us to account for the level of diversity on our boards. Without targets this is difficult to do.
It strikes me that we should go one step further than simply measuring board diversity through something like a dataset uploaded remotely. When we are assessed by regulators it would be great if they start to think about cultural measures that evidence boards actively seeking out alternative views through their diverse membership.
Are members from BAME communities sitting on boards enabled and encouraged to act as a conduit to their communities, and importantly does the board openly and transparently share data about services directly with local communities? These are activities that I have noticed BAME colleagues in our frontline services do naturally and regularly often using their connections and knowledge of local communities to enhance access to services for members from that community, but generally not something we as the most senior leaders in organisations do.
On the point of sharing information about communities with communities, how natural and logical - but ask yourself how often do we do it? In our trust we have run a Reverse Commissioning Group that has synthesised data about our services and broken it down by protected characteristics then through a group with local community members we shared the data with the purpose of getting feedback.
My surprise was the lack of surprise from community members about what the data told them. My experience through this work is that the most effective innovations for engaging with local communities come from local communities.
So my end thought – it’s not the diversity on a board that counts but how we create a culture on the board to enable colleagues from diverse backgrounds to flourish. That is what makes the difference and ultimately what improves patient outcomes
Ifti Majid is chief executive at Derbyshire Healthcare NHS Foundation Trust and co-chair of the BME Leadership Network. Read the report Chairs and non-executives in the NHS: the need for diverse leadership.