Together with two other colleagues from my Trust, I recently came to the end of my term as a Foundation Trust Patient Governor. At our leaving do, there was a wonderful thought provoking conversation which left me reflecting on the bridging role and unlocked potential of Governors.
Governors are a group of people from many different walks of life who bring a range of experience, skills and knowledge and the only people who are on the inside of the organisation without being on the payroll.
Being a Governor is rewarding and frustrating, a privilege and a great responsibility. I started with many assumptions and I left with great respect for the role and my fellow Governors.
There are 147 Foundation Trusts each with around 18 to 30 Governors according to the Foundation Trust Network. Governors ‘represent’ patients, public, staff and partners and form a Council of Governors, part of the formal Governance of a Foundation Trust. Patient and Public Governors are voluntary and elected by the members of the Foundation Trust.
The role and statutory duties of Governors are enshrined in legislation so despite being a voluntary role with only expenses covered it is a role which is formal and has significant responsibility including representing the interests of members and the public, holding the non-executive directors to account, ensuring non NHS activities don’t detrimentally affect the primary purpose of the Trust, appointing the chair and non executive directors and approving significant transactions.
In the formal guidance on the roles and responsibilities there are also a range of less formal activities carried out by Governors, some examples are provided in the section of the guidance titled ‘other activities’. It is these ‘other activities where I think the real value of Governors lies.
At the Trust where I was a Governor, we were involved in a whole range of activities, e.g. food satisfaction surveys, informal service improvement inquiries, working groups and engaging members. In undertaking these roles Governors become extremely knowledgeable about both the organisation and individual services. They are in a unique position as they are committed to the organisation but not paid, they are there to represent members and the public but are ‘insiders’.
As with every aspect of the NHS, the level of impact of Governors depends to a certain extent on relationships and the culture of the organisation. I saw a positive change over time in my role of the strength of voice of Governors within the organisation as trust was built and value given to the insights of Governors.
There are also some basic barriers which I think need to be addressed to help create empowering conditions for elected voluntary Governors and increase their impact and unlock their full value.
People who are considering becoming a Governor or new Governors need to understand the role they are taking on, e.g. there should be a job description and should always be an induction programme and resources committed to training and development support at a local level. Buddying/mentoring with more experienced Governors and with staff could be made widely available. Governors should also have equal access to the Trust electronic resources and as a matter of course an NHS email address and as good practice an online closed forum with the other Governors.
As I got to know other Governors in my time in the role, I realised that each individual brought an incredible and different set of skills and knowledge to the table beyond their valuable experience as patients. We had people experienced in catering, clinical services, business, cultural change, patient engagement and communications, most of this was relatively untapped resource.
Many Governors work incredibly hard, putting considerable hours and effort into supporting the development of their Trust. They are a bridge between patients and communities and the formal system and staff. They have access to an wealth of informal and formal information which gives them a unique perspective and set of insights which is rarely fully heard and utilised.
As a Governor you can speak to patients and staff in a much less formal way than other ‘governance’ roles and at the same time you have access to the Board. Whilst it is not the role of Governors to get involved in the operational side of services, Governors do spend time on the wards talking to patients, observing what is happening, they can work with services to highlight and tackle specific issues, sometimes acting as a sounding board and champion. This also helps them to become more fully informed and more effectively deliver their governance role on the Council.
So whilst I feel privileged to have been a Governor and I was lucky to have been involved in a Trust with excellent management, a very supportive co-ordinator and a really strong team of Governors, I do leave feeling that Governors are generally undervalued and that their true potential is still not fully understood.
Drawing on my own experience, here are five practical ideas for developing the role of Governor:
- Governors should be better supported to understand and deliver their role through a clear job description and well resources co-ordination and training and development support.
- To aid the development of relationships of trust, budding and mentoring type arrangements could be built across experienced and new Governors and with senior members of staff
- Each Governor brings with them a unique set of experiences, skills and knowledge. This should be highlighted and utilised.
- Governors should have access to the electronic and other supporting development/communication resources of the Trust. This should include training and support to use offline tools and social media to engage and understand the members of the Trust whose interest they are representing.
- Consideration should be given to removing barriers to diversity, e.g. actively promoting the role within under representative communities, shadowing opportunities, times and style of meetings/papers.
On a more strategic note, the Government is undertaking a significant review of NHS Provider Services led by Sir David Dalton. The insights of Governors are incredibly valuable. Their unique role of bridge between patients & communities & the staff and system could be further enhanced. I hope that in that review specific attention is paid to Governors and that in future models this role is evolved and the true potential of this fantastic and unique set of people are unleashed.
I would like to finish this post by saying thank you to the management, staff and in particular the other Governors of Sheffield Teaching Hospital Foundation Trust. It was a privilege to be part of a group of active citizens and an organisation so dedicated to delivering the best possible services and ultimately health and well-being outcomes for the patients and communities it serves.
For further information about Governors: