A report coordiated by ACEVO has been profiled this week, advising on good practice for realising the potential of governance.

Third sector on-line promoted this with the headline: “Charities should introduce formal appraisal procedures for trustees, Acevo report urges”.

However, this headine is more that a tad misleading, as the report does not urge charities to use formal appraisal procedures for Trustees.

Conversely the report makes is quite clear that Board Appraisal should be undertaken in a way that aligns with the culture and resources of an individual charity.

Two forms of Trustee appraisal are put forward:

1. Individual trustee appraisals. These range from formal reviews informed by written self-assessment, or less formal procedures involving scheduled conversations. These are frequently led by the chair.

2. Whole-board appraisals. This option was considered by many respondents to be a less stressful prospect for trustees. A whole-board appraisal would often be facilitated by an independent external source such as a consultant. Alternatively, two organisations might consider a board-to-board, peer-led approach, in which two boards mutually review and appraise each other’s governance standards.

Whichever methodology is used, the report highlights that the effectiveness of board appraisals depends greatly on organisational culture and behaviour – an organisational culture that encourages trustees to take accountability seriously, and reflect on their responsibilities and performance on an ongoing basis.

However, for the smaller more informal charities (84% of charities are purely volunteer led and run – with no paid staff), the whole-board appraisal could be argued as a more appropriate way forward.

A Third Sector article highlighted today that there has been an increase in volunteering this year of 7% amongst adults in Britain.
You would have thought we would have had a positive upbeat message for the actual article, but you can detect the aptly dour British spirit seeping through the paragraphs.

…and this stems from the interviews with charities (via NAVCA), where the findings found that 46 per cent of the organisations experienced no change in the public’s attitude towards volunteering and community engagement over the previous year.

The muffled strains of muted celebrations were captured with the quote: “However, while the trend for volunteering is travelling in the right direction, the type of volunteering is still predominantly focused on neighbourly goodwill gestures, even though charities are in greater need of more formal help.”

How can anyone put a negative spin on the 7% increase in volunteering this year being predominently focused on neighbourly goodwill gestures?

This increase might mean an extra 3 million people are taking the lead in their communities to help people out. If charities are unable to tap into this upsurge in community spirit, then they need to have a serious look to check how their volunteering strategy is failing to engage the spirit within the community.

An increase of hundreds of thousands of people helping their neighbours can only be good news! (for goodness sake!)

In 1948, AGL lves eloquently expressed the founding purpose, and prevailing culture of the voluntary hospitals as:
“ The desire to do something practical in relief of their fellow men and do it themselves, the readiness to accept responsibility rather than petition the King or corporation – this was the soil in which was to grow the voluntary hospital movement.”

I’m sure AGL Ives would be encouraged to hear that 65 years later, people up and down the land are ready to accept responsibility to help their neighbour, rather than petition the government to do it for them…(or petition the government to fund charities to do it for them).

Don Berwick leads on the report to improve the safety of patients in England:

Roy Lilley leads on the criticism of its contents: Stating he “hates its lack of grit and traction, and failure to take on the real issues”, and that Berwick has “tried to be too clever by half and the result is a report that only half deals with the solutions”.

Roy Lilley has to be congratulated for adding to the stimulus to read Don Berwick’s report in detail – I’m sure I and many others wouldn’t have made this a priority task in a busy week.

His key criticisms amounted to what the report didn’t say. According to Lilley, it didn’t say:
– Protect the front line – fund it properly, protect it fiercely, mandate its staffing and make it fun to work there.
– Make all Board members apply and qualify for a license to hold public office.
– Regulate HCAs.
– Dump the lunacy of Monitor and the CQC.
– Be honest about the money thing and how to get more for no more.
– Reorganisation has got you into this mess and you won’t reorganise your way out of it but you can unpick it, carefully.

So what do the Berwick recommendations, say?

These can be summarised and grouped in key themes as follows:

Strategic priority
NHS healthcare leaders should place quality of care and patient safety, at the top of their priorities for everything.

Learning
The NHS leaders should create and support the capacity for learning and the NHS should embrace an ethic of learning. Mastery of quality and patient safety sciences and practices should permeate all education thinking and practice.

Community engagement
Patients and carers should have influence at all levels of healthcare organisations. All organisations should seek out the patient and carer voice to monitor the safety and quality of care.

Staffing
All parties should assure sufficient staff are available to meet the NHS’s needs now and in the future. Healthcare organisations should ensure appropriate numbers of well-supported staff are present to provide safe care at all times.

Monitoring and control Systems
Transparency should be unequivocal. All data on quality and safety should be shared in a timely fashion with all. Supervisory and regulatory systems should be simple and clear, and embrace the goodwill and sound intention of the vast majority of staff.
Regulation of organisations should be responsive and tailored. Recourse to criminal sanctions should only function as a deterrent to wilful or reckless neglect or mistreatment.

So, it if feels as if Berwick is focusing on changing culture, and Lilley is suggesting some key strategies or tactics.

In this vein, two quotes come to mind:
“Culture eats strategy for breakfast” (Peter Drucker)
“Tactics without strategy is the noise before defeat” – (attributed to Sun Tzu – an ancient Chinese military general, strategist, and philosopher)

It could therefore be argued that Berwick’s recommendations would have more impact in creating a lasting legacy on improving the safety of patients, than Lilley’s suggestions. Looking through a glass darkly, it could be represented as one playing a game of chess whilst the other plays draughts…

But, do the Berwick recommendations lack grit and traction, as Lilley asserts?
It all depends on whether those responsible for leading healthcare organisations have the ability, will and opportunity to grasp and act on the challenge to develop a culture of learning, engagement and transparency. If the ability, will or opportunity are lacking, then Berwick will have misjudged the wider context of healthcare in England, and his recommendations will indeed “only half deal with the solutions”.

But, if those responsible for leading healthcare organisations can rise, and have the opportunity to rise to this challenge, then history might show Berwick’s report as a significant line in the sand in for safety of patients in England.

I came across a post today stating that employees will be more effective if managers are respecters of time – they ensure employees make time for rest, recovery and have fun in their day.

I couldn’t help thinking that focusing on ‘rest and recovery’ might encourage managers to treat the symptoms rather than the cause…?
Putting fun in your day sounds much more in the zone though.

In a CIPD Podcast on Talent Management (2007), Adrian Moorhouse, former Olympic swimming champion and now Managing Director of lane 4 comments on the work/life balance, and suggests we focus on making work feel like part of life(!):

“Matching the motivations, dreams and goals of an individual with the motivations, dreams and goals of an organisation – when you get those closely aligned then, I think, you’ve got a very motivated group of people because it’s not work, it’s life.”
http://www.cipd.co.uk/podcasts/_articles/article4.htm?view=transcript

If the whole of work is therefore also life, then the work/life balance for someone who works 40 hours a week is:
40/168 to 168, which equates to approx 1:4 (four times more life than work)

If work is not life and someone works 40 hours a week, then work/life balance is:
40:128, equating to approx 1:3 (three times more life than work).

So someone who can treat work as life, has approx 133% more life than someone who doesn’t, and throughout a 45 year career this equates to 15 years of extra life!!!

OK – So maths can’t really be applied in this context, but it’s an interesting thought… 😉