Decision, no decision: The challenges of board decision making

Abstract

This is the second of four articles that will explore a range of problem areas in foundation trusts (FTs) that have caused the trust to have been identified by the FT regulator Monitor (now NHS Improvement) for special attention. These problem areas focus on the board's insight into its business, the information it has for decision making, the effectiveness of the non-executive challenge function, and how executives are held to account. This learning is equally applicable to governing bodies of clinical commissioning groups. This article in the series considers information for decision making and how boards go about making decisions. Three key issues are explored: the process to turn data into information and then intelligence for decision-making; the way in which performance information is presented to the board to enable board members to ‘join the dots’ when considering what the information tells them; and improving the quality of board papers as a key output of a high quality corporate management process. The article explores the benefits of translating these areas into more effective decision making so that the board really adds value to the organisation. The article concludes with a set of actions that the board can implement so that its decision making is enhanced. Subsequent articles will focus on the challenge function within the board and its effectiveness in holding to account.