The latest analysis commissioned by Monitor indicates Foundation Trusts are making real progress in bringing local accountability to the NHS. This is fantastic news for hospitals and healthcare services and the communities they serve. Real people are finally feeling they are having a real influence on decisions that affect their healthcare. But what makes for a successful Trust? The answer lies in the Governors...
A successful Trust recognises that it's Board of Governors are, or should be, at the heart of their future plans. If FT's are about giving people on the front line more freedom, and patients more choice, then Governor's have a crucial role to play. They become the watchdogs where the Government has stepped back, and they become the hospital's advocates to the public, assisting in patient choice.
But this is a new role, even those that have been in place longest have really only been operating under their current set-up for a few years at most. Many have never done anything like this before. Indeed, it is questionable whether there has ever been a role like this before!
Monitor highlight that 4 out of 5 Governors are now clear about their roles and responsibilities, around half have exercised their statutory powers and many feel that they can adequately represent the needs of their constituents. But the real key to the success of the Governors is in the relationship they are able to build – and maintain – with the Trust Board.
At TCC we have found that empowering Governors to be effective in their roles requires offsetting high aspirations with realistic management of expectations. A committed, enthusiastic group of Governors is useless if their Board doesn't listen to them. Likewise, a Council of Governors ready to make executive decisions on the remuneration and allowances of the chair and executive board, for instance, is ineffective if they don't understand the roles and pressures of those they are keeping in check. It is vital that Governors are supported in their roles by the Trust Board, that they are given all the information and tools they need in order to be effective.
The next step, inevitably, will be to mobilise the Governors in helping create an engaged and active membership base for their Trusts. Where the focus has been on numbers, more numbers, attention is now shifting to engagement. Sustained membership recruitment will always be a concern for Trusts as patients continue to exercise their choice or move away from the area, and it will be the role of the Governors to keep their interest and to keep them involved. Creative communications techniques that are effective at getting information moving in both directions will be crucial where budgets are already stretched.
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