NHS Tayside Transformation Support Team: second progress report

AAG Recommendation 8 – Corporate Structure

"The Board should build on current restructuring of the senior executive team and recruitment of non-executive members, addressing skill-mix gaps, particularly for effective strategic planning and oversight. It should maximise opportunities for induction and development of non-executive members to ensure robust and effective governance and scrutiny of the executive function of the Board."

NHS Tayside's Assessment

"The Chief Executive revised the first and second tiers of the organisation structure in June 2017, with further enhancements planned over the January 2018 to March 2018 to allow for a focus on planning and performance. In the interim, additional external support has been secured to fulfil the planning and performance requirement. Phase 2 of the Human Resource and Organisational Development restructure was completed and the Operational Unit redesign has been signed off with transition for key roles in March 2018.

Board Development Events continue to be held every second month and a rolling programme of events are in place. The Board Secretary attended the Non Executive Members informal meeting on 16 November 2017 to discuss future topics for the programme and is scheduled to attend a further meeting on 8 February 2018.

In anticipation of the recruitment of the three new Non Executive Board Members by the Public Appointments Unit ( PAU) and four new stakeholder Non Executive Board Members, the Board Secretary has developed a bespoke induction programme for each Non Executive member given that they are recruited for their particular skill set so will have different needs. This programme will also include the core induction elements required for a Non Executive Board Member of Tayside NHS Board. The Chairman developed a core skills matrix for the appointment of these three new non-executive members and a short listing process was completed on the 11 December 2017 with representation from the Scottish Government Workforce Director and PAU. The interviews for these positions on Tayside NHS Board will be held in January 2018.

The appraisal process for the Non Executive Members starts during the induction process. The Chairman meets with the new Non Executive Member to discuss their individual skillset, areas of particular interest to them and to identify any possible development needs. Subsequently the Board Secretary meets with the Non Executive Member to discuss the development of their induction programme. In terms of ongoing development, NHS Tayside Board holds Development Sessions on a wide range of topics every two months for all Board members. The Chairman meets individually with each Non Executive Member four times a year to discuss development and to complete a yearly appraisal which follows the NHS Scotland approach.

Next Steps

The Chief Executive and Human Resources and Organisational Development Director will further review the Executive Directors portfolios with target completion by March 2018. Induction for the seven new Non Executive Board Members will be arranged around the new framework on an ongoing basis. The Board Development Programme will continue to be developed in conjunction with Board Members."

TST comment

We can confirm that we have seen action initiated to address all elements of the recommendation; for Executive and Non Executive Members, established and new additions. In each case, although progress has been made and recorded, it will be some months before any of the new initiatives are compete.

The review of Executive team functions, along with the recruitment of interim external support, will contribute to addressing skill mix issues and recognises the need to strengthen the Board's strategic focus and planning function for the future. This will be critical to underpin the work still required on the longer term aspects of the Transformation Programme and the anticipated shift 'from transaction to transformation'. We have also been encouraged by observations that indicate the Executive Directors are working better as a team.

In terms of new recruitment, the work done over the last few months to prepare for the recruitment of a tranche of new Non-Executive Directors should provide a strong foundation for ensuring that the process identifies, not just the best people for the role, but also that those selected complement the skills and experiences already represented on the Board. The tailored and refreshed Induction Programme which will be offered to them at the start of their tenure must ensure that they can quickly get up to speed with the knowledge they need to put their existing skills to best use.

This initial support must also be accompanied by a robust process which holds all Board Members, individually and collectively to account for how well they exercise their skills to promote the interests of the health board. The process described in the self-assessment above provides the opportunity for this to happen and could usefully be used to remind all members of the demands and strictures of corporate responsibility in challenging times.

TST rating in September 2017 = Amber
TST rating in January 2018 = Amber