Chris Hopson is Chief Executive of NHS Providers (formerly the Foundation Trust Network). Prior to this, Chris worked at HM Revenue and Customs (HMRC), in a number of board-level roles, Granada Media (later ITV) and was the first political adviser at the Department of Culture, Media and Sport.
What change would you make to boardrooms to make them more effective?
I’m a great fan of diversity. Go back 20 years and on most boards you’d have a preponderance of white male accountants or management consultants, whereas now we’re bringing a more diverse range of people to the board table. Not just gender and ethnic diversity but people with customer, technology or global perspectives. The evidence is pretty clear — greater diversity makes for better board discussions, better decisions and better business performance.
But the challenge is making that boardroom diversity a reality. If the Chairman and Chief Executive are committed to making this happen, it can happen. I saw the effort taken by senior civil service leaders, for example, to improve diversity when I was in the Civil Service and it had an impact. You just need to treat it like any other business activity — set goals, measure and adjust activity based on performance.
How does that relate to NHS boards?
If I’m honest, I was surprised by the lack of diversity on NHS boards. Coming from the outside, I assumed the NHS would have made the same progress as I’d seen in the civil service, but when I went to my first meeting of the trust chairs and chief executives we represent, the lack of ethnic diversity was the first thing I noticed. We all know in the NHS that we’ve got to address it, and some have started doing it, but there’s a long way to go still.
How have NHS boards changed over the years?
There are two trends I’ve noticed. First, the role of the board is becoming more complex, as we’re asking boards to do more and more. In the NHS, lots of things end up on the board’s to-do list — they are ultimately responsible for everything that happens in their trust and these are organisations carrying a huge degree of risk — people die if something goes wrong. If NHS boards did everything they’re asked to do, they’d be in permanent session. NHS boards need to be self-disciplined, and decide what to focus on.
Second, the pool of people we draw NHS board members from is expanding, especially on the NED side. In the old days, the key requirement for an NHS board member was being a member of “the local great and the good”. Now it’s about the financial, big organisation, IT or estates expertise people can bring. Having worked in a FTSE 100 plc, I’m struck by how large and complex some of the 230 trusts we represent are — the biggest employ up to 20,000 staff and turn over in excess of £1.25 billion a year. As a sector, NHS trusts account each year for £75 billion of public expenditure and employ more than a million staff.
Are NHS boards becoming more effective?
I’ve been consistently impressed by the calibre of people we’re attracting, particularly into NED roles. They regard the NHS as a national treasure, something which is reflected in the current 70th birthday celebrations, and many want to give something back. Which is probably why I’ve never come across anyone who’s working the amount of time they’re actually being paid for, they’re all working vastly more.
What’s your biggest bugbear?
My heart sinks when I see 250+ page board packs. There’s a real challenge in helping executives reduce complex topics into something that’s easy to grasp. You need sensible board packs to enable boards to use their time effectively.
What can the Government do to support NHS boards?
It’s no great secret that the NHS has become much more pressured over the last five years. The number of hospital trusts meeting their financial and performance targets, for example, can be counted on one hand. It’s been particularly difficult to watch NHS staff run increasingly ragged and yet still fail to achieve the task they’ve been set, however hard they’ve tried. So my one plea would be to set the NHS frontline a stretching but realistic and deliverable task that the vast majority of trusts can deliver if they perform well.
What is your proudest achievement?
I believe you can judge the health of a system or a large organisation by the quality of its senior leadership pipeline. Some years back we noticed a shrinking pipeline for Trust Chief Executive roles — not entirely surprising given how difficult the job now is. So, drawing on my experience of the Civil Service High Potential Development Scheme, a group of partners created an aspiring Chief Executive development program and I chair the programme board. The first two cohorts have graduated and out of the 28 graduates, 12 have already been appointed to Chief Executive roles. We’re just choosing the next cohort from 96 applicants which is really difficult given the quality of the applicants. I also particularly enjoy buddying / mentoring some of the program graduates.
What book is on your bedside table?
I’ve just finished Partition, by Barney White-Spunner. It’s a fascinating take on the partition of India and Pakistan, with a military perspective but also covering the dreadful human consequences.
What luxury item would you take on a desert island?
I’ve always wanted to learn the piano, so I’ll take one along — with a teacher!
What’s your golden rule?
Seek feedback on your performance, and act on it. Management literature shows that it’s the activity that’s most consistently likely to improve your own performance.