Foresight Partnership

Review of the future role of FE Colleges, Chaired by Sir Andrew Foster for Department for Education Skills and the Learning and Skills Council
By Adrienne Fresko CBE and Sue Rubenstein

There is now a growing body of evidence to support the view that enabling Boards regularly and systematically to reflect on the patient experience correlates closely with organisations that deliver higher quality services. This case study describes a systematic and rigorous approach to ensuring that patient experience is an area of performance that is effectively scrutinised by the Board.

This case study explores the interplay of a number of dilemmas including:

-Who is governance for?

-Board effectiveness when things get tough

-The place of regulatory assurance in ensuring accountability

The case study describes the approach that Bedfordshire and Luton Partnership Trust has taken to respond to these dilemmas, It sets out the process through which the board of this organisation reached the conclusion that it would not be able to achieve foundation trust status in its own right. In the public interest, the Board stood down to facilitate a takeover of the organisation by an existing foundation trust.

This case study explores how placing quality as a top priority of the board and therefore the organisation can contribute substantially to financial as well as quality turnaround. This case study also links to the dilemma ‘board effectiveness when things go wrong'

This case study addresses the dilemma – ‘Who is governance for’?    It also directly addresses the challenges of system governance.  The case study describes an innovative approach that Herefordshire Primary Care Trust and Herefordshire Local Authority have adopted to develop joint management arrangements. It explores the benefits and challenges of such an approach.

This case study describes an approach to tackling the thorny issue of reducing the demands on non-executive directors’ time while allowing them enough time to undertake their core roles

This case study has been written from the perspective of the chair of the PCT.

This case study is offered as a cautionary tale for Board members. It describes the ways in which pressures on NHS Boards can result in a failure to retain as a core purpose and focus of the board ensuring that the organisation is delivering safe, high quality care to its patients

This case study is provided as a cautionary tale to board members. It demonstrates the importance of ensuring that service quality and patient safety are at the heart of the organisation’s strategy and are not secondary to other objectives. It points to the role of the Board in ensuring that organisational systems reflect this commitment to patient safety and service quality. Significantly, it identifies the risks for NHS boards that remain insulated from processes of engagement that would allow them to triangulate board performance reports with the reality of staff concerns and the patient experience of care.

In the NHS, the connection between staff engagement and satisfaction and good patient experience is well established. John Lewis is well known for the way in which it puts staff engagement at the heart of how the business is managed. It operates a particular legal form including very specific shareholder and governance arrangements. However this case study describes the respects in which the underlying philosophy and many of its processes of engagement and information sharing offer valuable insights to the NHS.

The Board of the Co-Operative Group identified the importance of staff engagement in its recent process of transformation. This case study describes the ways in which the board ensured that this priority was translated into reality through shifts in the Board approach to performance management and encouraging new management approaches to the engagement of staff