Key indicators
FIGURE 1
- All statements received at least 80% agreement (that is 'agree' or 'strongly agree') which is above or in line with last year. This excludes 'NEDs challenge appropriately at board and committees', which is a new statement for this year and is intended to set a baseline for future monitoring.
- 98% of respondents agreed, or strongly agreed, with the statement 'Board directors understand how directors' behaviour both at and outside the board establishes and models the organisational culture' – the highest proportion of any statement and a seven percentage point increase on last year's survey.
- 'Executive directors at my trust provide constructive challenge to the board' received the lowest level of agreement (80%) of any statement and this was also the case last year (77%). 16% of respondents said that they neither agreed nor disagreed and 4% disagreed.
- The only statement to receive a 'strongly disagree' response was 'executive directors on the trust board allocate adequate priority to fulfilling their board role' (1%).
Board directors understand how directors' behaviour both at and outside the board establishes and models the organisational culture
- Responses from chairs and governance leads were similar.
- All trust types apart from combined acute and community trusts and combined mental health/learning disability and community trusts agreed 100% of the time that board directors understand how directors' behaviour both at and outside the board establishes and models the organisational culture. Agreement was lowest for combined mental health/learning disability and community trusts (89%),which is the same result as last year.
Executive directors are effective in their trust board role as well as their managerial role
- Chairs and governance leads responded with high levels of agreement (chairs: 91%, governance leads: 96%).
- Looking at responses by trust type, members from community trusts were the most likely to strongly agree with this statement (89%) compared to other trust types and the survey average (44% strongly agree), as was found last year.
FIGURE 2
- Chairs were less likely to agree and had higher levels of neutrality than governance leads. 87% of governance leads agreed (54%) or strongly agreed (33%), compared to 67% of chairs agreeing (54%) or strongly agreeing (13%). Over a quarter (26%) of chairs neither agreed nor disagreed.
- Over 10% of respondents from all trust types felt neutral or disagreed.
- Community trusts were more likely to strongly agree (56%) than other trust types and the survey average (26%).
Executive directors contribute to organisational strategy outside their own discipline
- There was little variation between chairs and governance leads: both had large proportions of respondents who agree. However, governance leads were more likely to strongly agree (42%) compared to chairs (26%).
- All (100%) ambulance, community and mental health/learning disability trust members agree that executive directors contribute to organisational strategy outside their own discipline. Combined mental health/learning disability and community trust members were the most likely to disagree (6% disagree), the same as last year.
FIGURE 3
Executive directors on the trust board allocate adequate priority to fulfilling their board role
- Nine in ten (90%) governance leads agreed (47% agree, 43% strongly agree), compared to 80% of chairs (52% agree, 28% strongly agree). Chairs were more likely to disagree (9%) compared to governance leads (2%), but with similar levels of neutrality (11% chairs, 8% governance leads).
- All (100%) respondents from acute specialist, ambulance and mental health/learning disability trusts agreed with this statement. Agreement from acute members (76%) was the lowest of all trust types and lower than the survey average (86%), with nearly one in five (18%) of respondents responding neutrally and 6% disagreement.
Executive directors understand the trust board's role and its value to the organisation
- All trust types other than acute and combined mental health/learning disability and community trusts agreed with this 100% of the time. Acute trusts were most likely to be neutral (9%).
NEDs are able to use the information they receive at board and committees to gain assurance about the performance of any trust
- Responses between trust types were similar, with almost all respondents agreeing or strongly agreeing with this statement. 9% of acute trusts were neutral and a small proportion of combined mental health/learning disability and community trusts and combined acute and community trusts disagreed.
NEDs challenge appropriately at board and committees
- There was a high level of agreement with this statement amongst all trust types and no disagreement. A small proportion of mental health/learning disability (8%), acute trusts (7%), and combined mental health/learning disability and community trusts (6%) were neutral about this statement.
If you disagreed with any of the statements, please tell us more, or feel free to explain any of your answers:
- In the comments, some respondents highlighted the difficulty that executives face in balancing board responsibilities with the demands of operational leadership, as there is often a pull towards short-term crises.
- Governance leads noted that there are varying levels of experience among NEDs regarding their role in governance, with some also raising concerns about the volume of information. Chairs noted that NEDs often dominate discussions and engage too deeply in operational details, which can overshadow collaboration and create tension with executives.
- Respondents also mentioned that executives and NEDs can experience difficulty in challenging each other effectively, especially within larger or younger boards.
"Our executive has necessarily been involved in making swift operational improvements and this makes the ability to step back and constructively challenge as part of the wider board difficult. Getting back into a more strategic space will be a priority for 2025.”
Company Secretary
“The trust is currently doing an in-depth review of assurance v reassurance. Having worked across a
number of Trusts recently I professionally think that NEDs are mixed, and it is not collectively understood
how to challenge effectively. Execs can often find the process personal rather than a positive mechanism.”
Director of Corporate Affairs, Acute Trust
"The volume of information received makes it difficult to ensure challenge on everything. We are working hard to reduce this but with recovery, business as usual, improvement and external scrutiny this is more challenging for our trust.”
Company Secretary, Acute Trust