NHS crisis foretold

GIVEN the extremely serious unprecedented crisis in the NHS it is highly regrettable that there is not a much greater public awareness of the views of those responsible for the day to day running of the NHS – namely, NHS Trust Chairs and Board Members.

The reluctance to release advisory public statements while also not giving media interviews creates an information and knowledge vacuum into which wild, partisan, authoritative and nonsensical opinions easily flood without distinction.

My book Independent Director in Society (co-authored with Professor Andrew Kakabadse and Dr. Filipe Morais) researched the candid opinions of NHS Trust Chairs and NHS Trust executives and they can still help guide possible responses to the current state of the NHS. 

In all 203 confidential NHS surveys were conducted by Henley Business School. Interviewees include 58 Chairman/Chairwomen, 7 CEO’s and 132 Executives/Non-Executives/Trustees further fleshed out by many interviews with key NHS thought and opinion-leaders^.

These views from the front lines from experts still or previously working with NHS Providers, NHS Confederation and NHS Improvements along with statistics and actionable recommendations reported by Henley Business School means this research arguably remains the most up-to-date independent original source into the various crises besetting the NHS. 

This research is even more vital, insightful and important now – particularly since so many of its worries, predictions and warnings have come true - than when first published. 

The principle conclusion from our research was and is that the NHS suffers from a Governance Crisis and its associated problems cannot be solved until its mandate is substantially reduced.

Our research survey findings also reveal:

  • 1 in 5 believe it is impossible to deliver against NHS mandate
  • 9 out of 10 cite lack of resources
  • 9 out of 10 cite inability to cope with future challenges
  • over 8 out of 10 note long-term damage to reputation/image
  • 1 in 10 have zero meetings to discuss strategy
  • 1 in 3 of all board meetings are over 6 hours
  • nearly 4 in 10 say board ability to handle sensitive discussions is average to poor
  • Only 1 in 4 have an annual external review of performance

The NHS also suffers from structural corporate governance problems found elsewhere in other sectors (sport, charity and education) also surveyed in my book, namely:

  • Boards are failing to be effective
  • Training for directors is sparse to the point of non-existence
  • There is a serious lack of diversity
  • The consequences of Board and Independent Director ineffectiveness are dreadful 
  • Understanding of digital economy issues and grasp of data are poor
  • Directors themselves are failing to perform their duties
  • Regulatory exhaustion is increasingly common



^ NHS/Health movers and shakers survey interviewees include:

Chris Hopson, Chief Strategy Officer, NHS England

Dame Angela Pedder, Former CEO, Royal Devon and Exeter Foundation Trust

Dr Dipti Amin, Chief Medical Informatics Officer, Johns Hopkins All Children's Hospital; Non-Executive Director, Buckinghamshire Healthcare NHS Trust

Elizabeth Drew, ex-Chairwoman, Helen & Douglas House

Heather Lawrence, ex-Chair, London Ambulance Trust 

John Carrier, ex-Chairman, North Middlesex University Hospital NHS Trust; Public Governor, Royal Free London, NHS Hospital Trust

Lord Nigel Crisp, Former Chief Executive & Permanent Secretary, NHS / Department of Health; co-Chair All Party Parliamentary Group on Global Health

Niall Dickson, ex-CEO, NHS Confederation; Chair East Kent Hospitals University Foundation Trust

Prof John Caldwell, Former Chairman, Mid-Staffordshire NHS Foundation Trust; Chairman, Health Education Thames Valley

Emeritus Professor Dorothy Griffiths, OBE, Chairwoman, Central Northwest London NHS Foundation Trust

Professor Nick Pearce, Director of the Institute for Policy Research (IPR), Professor of Public Policy, Bath University

Sarah Boulton, Chair, East Anglia Ambulance Trust; Chair Healthy Boards 

the late Sir Peter Thompson, Former Chairman, NFC plc; Former Chairman, Community Hospitals PLC


Photo credit: Getty Images/BBC