The last few weeks have been challenging on many levels. As our deputy chief executive said in his report to our council in May, it is a ‘time of anxiety, loss, discovery, and growth’. Guidance from NHS England and Improvement on ‘easing the burden’ recommended limiting engagement with members and public stakeholders. What then, should be the role of the council?
At East London NHS Foundation Trust (ELFT), we have traditionally looked at the council more widely than its statutory and regulatory function and focused on the added value - the skills, insights (and passion) our governors can bring to the trust.
A meeting of the chair, vice chair and four governors (lead and deputy lead governors and the two chairs of the council’s standing committees) in March led us to focus on a COVID-19 council engagement plan, subsequently discussed and agreed by the whole Council, and supported by the board.
The council needed to remain engaged and informed to:
- carry out specific statutory duties (such as recruiting a new chair for the trust)
- carry out its duties of holding the non executive directors to account as well as feedback information from their constituencies. Both of these we deemed especially important at a time where decisions needed to be taken quickly, and services redesigned at pace
- retain its culture as one of constructive challenge based on mutual trust and mutual respect between the council and the board
- engage governors now in our discussions around shaping the future – about what type of trust we want to see emerge once we find our balance again
- ensure governors could find support, as well as support each other, in what is for many a very difficult time.
This document contains more about our activities, but I’d like to highlight a few of them:
Our long-standing chair Marie Gabriel left at the end of March. While we have an outstanding interim chair, the fact that our chief executive is due to move to HEE later this year and that the process had started before COVID-19 meant recruiting a new chair really needed to be progressed.
We surveyed our members and stakeholders on the essential qualities of a chair for ELFT and had more than 400 replies which helped inform the council and the board’s work on the person specification. Following lock down and social distancing requirements we opted for four stakeholder panels to involve the widest possible range of stakeholders. These, like the interview panel, were held by video conference. Twelve stakeholder sessions with about 12 members in each were held over one morning, with the interviews following in the afternoon.
The process went very smoothly and gave the wider council a high degree of assurance that the process had been fair, transparent, had left (in the words of our lead governor) ‘no stone unturned’, and had led to the right outcome.
As a follow up, we have asked participants to give us a very simple rating on a scale of 1-5 where 1 = the process was much worse than a face to face meeting, and 5 = the process was much better than a face to face meeting.
The average response for the rating was 3.5, so ever so slightly better than a face to face meeting. Feedback from service users and governors seemed to focus on the ability to be heard and listened to in a structured meeting, to be able to give feedback, not to be overwhelmed by a large gathering. Feedback from board members and external stakeholders focused on the ease of access, no travel time, time to do other work between stakeholder meetings – as well as an interesting challenge for the candidates to respond to.
The trust is now starting to look at the learning from the past weeks and how we see us emerge from the current crisis into a new equilibrium.
We now offer fortnightly video conferences for governors, one on a weekend (as weekends can be particularly difficult for those socially distancing) and one on a weekday, with attendance about ten at each. The meetings are as much a social check-in with each other and how we are coping as a mechanism to talk through our most recent update. Governors also feed back what they are hearing in their communities – this is something we will pick up and feed back to them once resolved. These meetings have been really useful to strengthen the council’s cohesion – and add value for the Trust as we hear first-hand what impact COVID-19-mandated service changes may have. They have also been a useful reminder to governors of their power of enquiry.
Shaping the future
The trust is now starting to look at the learning from the past weeks and how we see us emerge from the current crisis into a new equilibrium. An initial webinar to staff members soon turned into the idea of an interactive workshop with governors.
This was a high-level strategic view of what lessons have been learnt (for example, as a service provider in Newham we cannot avoid the fact that Newham had the highest mortality rate for COVID-19 in the UK), what our priorities are and where we as a trust focusing on wider population health issues are heading. This is an important discussion and we need to hear the council’s voice; but it is not one we could have had with governors had we decided in March to cut them off from any meaningful information and engagement.
We have traditionally shared a wide range of information with our governors. We are continuing this, including a new regular update from the chief medical officer. We are also restarting our meetings with local governors and their respective Borough directors. In addition, governors regularly attend the public board meetings which are held by video conference and we are aiming for a short high-level summary of board decisions soon after each meeting.
There's also been surprisingly a pastoral role for the governors and members office. These are unsettling times and times of greater health risk for sometimes elderly governors. We reassure and we check on people we haven’t heard from in a while, or we offer personal support when we give trust iPads to those who have no internet access at home. We also make adjustments so that those with disabilities are not too unsettled by the break in routine.
The last few weeks have left me deeply impressed with our governors all over again: their determination to contribute, to help us improve, to challenge the trust where necessary. But also their willingness to look out for each other (and for me!) and, for some, to venture miles outside their comfort zone when it comes to using IT. They’re living our trust values, and the ELFT promise: to work together to learn what matters to improve our services.
Find out more about the governance support we are offering our members at the moment by visiting our online support hub.