1. Driving high-quality and sustainable outcomes

What does good look like?

I am a member of a unitary board which is committed to ensuring excellence in the delivery (and / or the commissioning) of high quality and safe care within our limited resources, including our workforce. I seek to ensure that my organisation* demonstrates continual improvement and that we strive to meet the standards expected by our patients and communities, as well as by our commissioners and regulators, by increasing productivity and bringing about better health and care outcomes with lasting change and improvement.

* All references to “organisation” also refer to systems for board members of integrated care boards.

Competencies

1. I contribute as a leader:

a.  to ensure that my organisation delivers the best possible care for patients

b.  to ensure that my organisation creates the culture, capability and approach for continuous improvement, applied systematically across the organisation

2. I assess and understand:

a.  the performance of my organisation and ensure that, where required, actions are taken to improve
b.  the importance of efficient use of limited resources and seek to maximise:

i. productivity and value for money

ii. delivery of high quality and safe services at population level

c.  the need for a balanced and evidence-based approach in the context of the board’s risk appetite when considering innovative solutions and improvements

3. I recognise and champion the importance of:

a. attracting, developing and retaining an excellent and motivated workforce
b. building diverse talent pipelines and ensuring appropriate succession plans are in place for critical roles
c. retaining staff with key skills and experience in the NHS, supporting flexible working options as appropriate

4. I personally:

a. seek out and act on performance feedback and review, and continually build my own skills and capability
b. model behaviours that demonstrate my willingness to learn and improve, including undertaking relevant training

2. Setting strategy and delivering long-term transformation

What does good look like?

I am a member of a unitary board leading the development of strategies which deliver against the needs of people using our services, as well as statutory duties and national and local system priorities. We set strategies for long term transformation that benefits the whole system and reflects best practice, including maximising the opportunities offered by digital technology. We use relevant data and take quality, performance, finance, workforce intelligence and proven innovation and improvement processes into account when setting strategy.

Competencies

1. I contribute as a leader to:

a. the development of strategy that meets the needs of patients and communities, as well as statutory duties, national and local system priorities
b. ensure there is a long-term strategic focus while delivering short-term objectives
c. ensure that our strategies are informed by the political, economic, social and technological environment in which the organisation operates
d. ensure effective prioritisation within the resources available when setting strategy and help others to do the same

2. I assess and understand:

a. the importance of continually understanding the impact of the delivery of strategic plans, including through quality and inequalities impact assessments
b. the need to include evaluation and monitoring arrangements for key financial, quality and performance indicators as part of developing strategy
c. clinical best practice, regulation, legislation, national and local priorities, risk and financial implications when developing strategies and delivery plans

3. I recognise and champion the importance of long-term transformation that:

a. benefits the whole system
b. promotes workforce reform
c. incorporates the adoption of proven improvement and safety approaches
d. takes data and digital innovation and other technology developments into account

4. I personally:

a. listen with care to the views of the public, staff and people who use services, and support the organisation to develop the appropriate engagement skills to do the same
b. seek out and use new insights on current and future trends and use evidence, research and innovation to help inform strategies

3. Promoting equality and inclusion, and reducing health and workforce inequalities

What does good look like?

I am a member of a unitary board which identifies, understands and addresses variation and inequalities in the quality of care and outcomes to ensure there are improved services and outcomes for all patients and communities, including our workforce, and continued improvements to health and workforce inequalities.

Competencies

1.    I contribute as a leader to:

a. improve population health outcomes and reduce health inequalities by improving access, experience and the quality of care
b. ensure that resource deployment takes account of the need to improve equity of health outcomes with measurable impact and identifiable outcomes
c. reduce workforce inequalities and promote inclusive and compassionate leadership across all staff groups

2. I assess and understand:

a. the need to work in partnership with other boards and organisations across the system to improve population health and reduce health inequalities (linked to Domain 6)

3. I recognise and champion:

a. the need for the board to consider population health risks as well as organisational and system risks

4. I personally:

a. demonstrate social and cultural awareness and work professionally and thoughtfully with people from all backgrounds
b. encourage challenge to the way I lead and use this to continually improve my approaches to equality, diversity and inclusion and reducing health and workforce inequalities.

4. Providing robust governance and assurance

What does good look like?

I understand my responsibilities as a board member and how we work together as a unitary board to reach collective agreement on our approach and decisions. We use a variety of information sources and data to assure our financial performance, quality and safety frameworks, workforce arrangements and operational delivery. We are visible throughout the organisation and our leadership is underpinned by the organisation’s behaviours, values and standards. We are seen as a Well Led organisation and we understand the vital importance of working collaboratively.

Competencies

1. I contribute as a leader by:

a. working collaboratively on the implementation of agreed strategies
b. participating in robust and respectful debate and constructive challenge to other board members
c. being bound by collective decisions based on objective evaluation of research, evidence, risks and options
d. contributing to effective governance and risk management arrangements
e. contributing to evaluation and development of board effectiveness

2. I understand board member responsibilities and my individual contribution in relation to:

a. financial performance
b. establishing and maintaining arrangements to meet statutory duties, national and local system priorities
c. delivery of high quality and safe care
d. continuous, measurable improvement

3. I assess and understand:

a. the level and quality of assurance from the board’s committees and other sources
b. where I need to challenge other board members to provide evidence and assurance on risks and how they impact decision making
c. how to proactively monitor my organisation’s risks through the use of the Board Assurance Framework, the risk management strategy and risk appetite statements
d. the use of intelligence and data from a variety of sources to recognise and identify early warning signals and risks – including, for example, incident data; surveys; external reviews; regulatory intelligence; understanding variation and inequalities.

4. I recognise and champion:

a. the need to triangulate observations from direct engagement with staff, patients and service users, and engagement with stakeholders
b. working across systems, particularly in responding to patient safety incidents, and an understanding of how this links with continuous quality improvement

5. I personally:

a. understand the individual and collective strengths of the board, and I use my personal and professional knowledge and experience to contribute at the board and support others to do the same

5. Creating a compassionate, just and positive culture

What does good look like?

As a board member I contribute to the development and ongoing maintenance of a compassionate and just learning culture, where staff are empowered to be involved in decision making and work effectively for their patients, communities and colleagues. As a member of the board, we are each committed to continually improving our approach to quality improvement, including taking a proactive approach and culture.

Competencies

1. I contribute as a leader:

a. to develop a supportive, just and positive culture across the organisation (and system) to enable all staff to work effectively for the benefit of patients, communities and colleagues
b. to ensure that all staff can take ownership of their work and contribute to meaningful decision making and improvement
c. to improve staff engagement, experience and wellbeing in line with our NHS People Promise (for example, with reference to equality, diversity and inclusion; freedom to speak up; personal and professional development; holding difficult conversations respectfully and addressing conflict)
d. to ensure there is a safe culture of speaking up for our workforce

2. I assess and understand:

a. my role in leading the organisation’s approach to improving quality, from immediate safety responses to creating a proactive and improvement-focused culture

3. I recognise and champion:

a. being respectful and I promote diversity and inclusion in my work
b. the ability to respond effectively in times of crisis or uncertainty

4. I personally:

a. demonstrate visible, compassionate and inclusive leadership
b. speak up against any form of racism, discrimination, bullying, aggression, sexual misconduct or violence, even when I might be the only voice
c. challenge constructively, speaking up when I see actions and behaviours which are inappropriate and lead to staff or people using services feeling unsafe, or staff or people being excluded in any way or treated unfairly
d. promote flexible working where possible and use data at board level to monitor impact on staff wellbeing and retention

6. Building trusted relationships with partners and communities

What does good look like?

I am part of a board that recognises the need to collaborate, consult and co-produce with colleagues in neighbouring teams, providers and systems, people using services, our communities and our workforce. We are seen as leading an organisation that proactively works to strengthen relationships and develop collaborative behaviours to support working together effectively in an integrated care environment.

Competencies

1. I contribute as a leader by:

a. fostering productive partnerships and harnessing opportunities to build and strengthen collaborative working, including with regulators and external partners
b. identifying and communicating the priorities for financial, access and quality improvement, working with system partners to align our efforts where the need for improvement is greatest

2. I assess and understand:

a. the need to demonstrate continued curiosity and develop knowledge to understand and learn about the different parts of my own and other systems
b. the need to seek insight from patient, carer, staff and public groups across different parts of the system, including Patient Safety Partners

3. I recognise and champion:

a. management, and transparent sharing, of organisational and system level information about financial and other risks, concerns and issues
b. open and constructive communication with all system partners to share a common purpose, vision and strategy