Publication - Advice and guidance

Being Effective - What NHS Non-Executive Directors Need to Know

Published: 4 Nov 2015
Part of:
Health and social care

Resource booklet for NHSScotland Board Members, with an interest in governance.

36 page PDF

323.8 kB

36 page PDF

323.8 kB

Being Effective - What NHS Non-Executive Directors Need to Know
Formulating Strategy

36 page PDF

323.8 kB

Formulating Strategy

The first of the three roles of the Board is formulating strategy. This incorporates:

  • the process of strategy development,
  • having an effective strategy; and
  • strategic leadership and decision-making.

Strategy development

Strategy development should provide for active involvement of staff and engagement with patients and the wider community. An effective strategy should:

  • be underpinned by a clear vision, purpose and be outcomes focused;
  • take account of external context and drivers;
  • be based on well-informed data; and
  • take a long term view.

Whilst the NHS Board Chair sets the vision, the NHS Chief Executive leads strategy development and the Executive Team develop strategic proposals on how to implement government policy, a Non-Executive Director’s role is:

to provide independent oversight, external perspectives, skills, and challenge to strategy development.

Knowledge and skills

To challenge effectively, Non-Executive Directors need to have a good understanding of the Scottish Government priorities as well as the operational environment in which the organisation operates. They will also need to have the ability to:

  • analyse and review complex information;
  • weigh up conflicting issues, make decisions;
  • question and challenge information constructively; and
  • seek out further information and engage with stakeholders.

Further information

There are a lot of resources available which describe the role of the Non-Executive Director and the process of strategy development. The challenge lies in finding resources to support new Non-Executive Directors to develop their skills.

Tips for new Non-Executive Directors for developing practical skills:

  • do your background reading, be familiar with Scottish Government policies and priorities;
  • get as much exposure as you can, by attending committees, and meetings of other NHS Boards;
  • sign up for a mentor or ask to be ‘buddied’ with more experienced Non-Executive Directors; and
  • get out and about, speak to staff, patients and members of the community.

What Non-Executive Directors can do to assist effective strategy development:

  • scrutinise the strategic plan to make sure that there is a clear link between the vision, purpose and objectives, and that it is focused on achieving outcomes;
  • check that the strategic plan takes account of the external context and drivers of the
    NHS Board;
  • ask the leaders of the NHS Board to explain what evidence/information has been used to underpin the strategy;
  • check that the strategic plan takes a longer term view;
  • satisfy yourself that there has been regular discussion in the NHS Board meetings to update and review the strategic plan;
  • scrutinise the strategic plan for evidence that staff have been involved, ask staff if they have been actively involved in development; and
  • ensure that there been open, transparent, accountable consultation and involvement with patients and the community.

Further Information

Health Management Library provides a national library and knowledge service for management and leadership topics. There is a physical library in Edinburgh and an online library You can borrow books, sign up for their current awareness bulletins or request a literature search.

The National Leadership Unit provide information and resources to support leadership development

Other useful reading materials:

Effective behaviour in the boardroom, 2013, The Kings Fund (online)

What makes a board effective, 2013, The Kings Fund (online)


Email: Sarah Hildersley