ORCID
- Sheaff, Rod: 0000-0002-7984-2627
- Jones, Ray: 0000-0002-2963-3421
Abstract
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.
DOI
10.1186/s12913-015-1127-2
Publication Date
2015-10-15
Publication Title
BMC Health Services Research
Volume
15
Organisational Unit
Peninsula Medical School
Keywords
corporate governance, clinical governance, Non-executive directors, Interaction between directors, perlocution
First Page
1
Last Page
1
Recommended Citation
Sheaff, R., Endacott, R., Jones, R., & Woodward, V. (2015) 'Interaction between non-executive and executive directors in English National Health Service trust boards: an observational study', BMC Health Services Research, 15, pp. 1-1. Available at: https://doi.org/10.1186/s12913-015-1127-2
