NHS Fife and Dumfries & Galloway - good practice in planning and assessment - 2015

Key learning outcomes

• You can appoint people who don’t have more traditional governance skills when those are already well represented on the board. This allows you to appoint people with perspectives and backgrounds that would otherwise be lacking such as a clear understanding of disadvantaged communities. This isn’t about creating two tier boards. Everyone has a valuable and different contribution to make   
• For this approach to be successful you have to make significant changes to more traditional methods for application and assessment

Background

The NHS in Scotland runs a relatively high number of public appointment rounds for board chairs and members every year. The number of rounds and the experience gained from them means that it is possible to develop and test new and innovative approaches, intended to focus on improving the diversity of NHS Board membership in Scotland, more frequently.  

During 2014 the Scottish Government Health and Social Care Directorates, working closely with the Scottish Government’s central Public Appointments Team (PAT) and our office undertook three rounds where new approaches were developed and tested.

The outcome of the NHS Lanarkshire round was the first of these published on our website as a good practice case study. However, it was recognised that there were a number of lessons which had emerged from that experience and so it was decided to apply them in two further rounds in NHS Fife and NHS Dumfries & Galloway respectively.  Both rounds were completed by the end of 2014.

Planning

In both cases, based on the views of the appointing minister, the intention was to appoint people: 

• with a deep understanding of disadvantaged communities in the areas concerned and
• considerable knowledge of the experience of service users and carers and of having to overcome barriers in different aspects of their lives.  

Everyone involved in planning for the appointments recognised that in order to reach, attract and ultimately appoint people who were truly representative of disadvantaged communities, or who had service user and carer experience, that different approaches to advertising and assessment would be necessary.  

They also recognised that applicants from ‘non-traditional’ backgrounds may have never served on a board of governance or had experience in large complex organisations. The panels for each appointment round had to design a process that both complied with the Code and at the same time sought to provide every opportunity for participation and engagement for people new to the public appointments process.

At the planning stage, both panels carefully considered the following issues:

• the skills, knowledge and experience which would be assessed and how to frame them so that the right people could apply successfully and so that the public could be assured that the appointments were made on the basis of merit
• the design of the application form -  care was taken to ensure it was not overly complex or daunting, while still offering applicants the opportunity to provide a broad range of information about themselves and their experiences
• how these opportunities would be advertised - the panels agreed not to use print media, but to rely instead on social media, networking and awareness raising but with extensive activity to reach into communities in new ways
• the interview stage - the panel agreed that there should be a move away from the standard interview format to one which was intended to be more informal in terms of the environment and approach.  This meant asking applicants to offer their perspective on a question provided in advance which the panel then used to facilitate a discussion on a semi-structured basis rather than the more traditional questions and answers approach.  It was still necessary for the panel to be satisfied that the evidence was captured and written-up, but it meant that the discussion was more natural and free flowing than can be the case in a traditional structured interview. The panel could still probe and seek clarity, but in ways which were carefully designed to help the applicants engage in a process which might be unfamiliar to them.

Conclusion

In the case of both the NHS Fife and NHS Dumfries & Galloway rounds, many more ‘non-traditional’ candidates applied and got further through the assessment process.  Overall, there were 25 applications in NHS Fife and 70 applications in NHS Dumfries & Galloway.

The appointments which were made demonstrated the impact of the emphasis placed on diversity, different skills, experience and backgrounds than has been seen in other public appointment rounds in the NHS.  

Commenting on the outcome, Phil Jones, the Chair of NHS Dumfries and Galloway said:

“for NHS Dumfries and Galloway the approach facilitated the appointment of two outstanding young women to a Board that celebrates diversity and champions equality.  The balance of the Board delivered by the new approach is good and we now have an environment and culture that encourages everyone to bring their own unique perspective to bear and contribute to the ongoing development of a health organisation.”  

Subsequently, both NHS Fife and NHS Dumfries and Galloway designed bespoke induction arrangements recognising that additional and ongoing support might be necessary for new members coming from different backgrounds.

Further information about the new board members is available from:

• NHS Fife (www.nhsfife.org): Moira Adams, Martin Black and Christina Cooper
• NHS Dumfries and Galloway (www.nhsdg.scot.nhs.uk): Lesley Bryce and Grace Cardozo

You can also find out more about who was appointed from the news releases:

• Members appointed to NHS Dumfries and Galloway (February 2015)
• Members appointed to NHS Fife (February 2015) 

The learning from the NHS Fife and NHS Dumfries & Galloway has since been used for other public appointments rounds.