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dc.contributor.authorSheaff, WRen
dc.contributor.authorEndacott, Ren
dc.contributor.authorJones, Ren
dc.contributor.authorWoodward, Ven
dc.descriptionResearch funded by Burdett Foundationen

Background National Health Service (NHS) trusts, which provide the majority of hospital and community health services to the English NHS, are increasingly adopting a ‘public firm’ model with a board consisting of executive directors who are trust employees and external non-executives chosen for their experience in a range of areas such as finance, health care and management. In this paper we compare the non-executive directors’ roles and interests in, and contributions to, NHS trust boards’ governance activities with those of executive directors; and examine non-executive directors’ approach to their role in board meetings. Methods Non-participant observations of three successive trust board meetings in eight NHS trusts (primary care trusts, foundation trusts and self-governing (non-foundation) trusts) in England in 2008–9. The observational data were analysed inductively to yield categories of behaviour reflecting the perlocutionary types of intervention which non-executive directors made in trust meetings. Results The observational data revealed six main perlocutionary types of questioning tactic used by non-executive directors to executive directors: supportive; lesson-seeking; diagnostic; options assessment; strategy seeking; and requesting further work. Non-executive board members’ behaviours in holding the executive team to account at board meetings were variable. Non-executive directors were likely to contribute to finance-related discussions which suggests that they did see financial challenge as a key component of their role. Conclusions The pattern of behaviours was more indicative of an active, strategic approach to governance than of passive monitoring or ‘rubber-stamping’. Nevertheless, additional means of maintaining public accountability of NHS trusts may also be required.

dc.format.extent1 - 1 (10)en
dc.subjectcorporate governanceen
dc.subjectclinical governanceen
dc.subjectNon-executive directorsen
dc.subjectInteraction between directorsen
dc.titleInteraction between non-executive and executive directors in English National Health Service trust boards: an observational studyen
dc.typeJournal Article
plymouth.journalBMC Health Services Researchen
plymouth.organisational-group/Plymouth/00 Groups by role
plymouth.organisational-group/Plymouth/00 Groups by role/Academics
plymouth.organisational-group/Plymouth/Faculty of Business
plymouth.organisational-group/Plymouth/Faculty of Business/Plymouth Business School
plymouth.organisational-group/Plymouth/Faculty of Health and Human Sciences
plymouth.organisational-group/Plymouth/Faculty of Health and Human Sciences/School of Nursing and Midwifery
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA20 Social Work and Social Policy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
dc.rights.embargoperiodNo embargoen
rioxxterms.typeJournal Article/Reviewen

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