Ensuring independence around our policy work

We attach great importance to the quality and independence of our published work. This page describes the arrangements put in place to ensure that.

The board of trustees sets the strategy for the Fund and the amount of funding that can be drawn down from the endowment to implement the strategy. The Board also approves the operational plan which identifies priorities for the annual work programme. The plan describes in broad terms the main areas in which the Fund will work and gives examples of projects to be undertaken during the year in question.

Twice a year our General Advisory Council (GAC) meet. This group comprises individuals with a wide range of experience across health and social care including patient advocates, health professionals, policy experts and experienced leaders within health and social care. The GAC provide insight and may offer comment and suggestions for the future work programme of the Fund. 

The senior management team works within the framework set by the strategy and the operational plan, and produces detailed work programmes in different areas of activity. The policy work programme is primarily led by the director of policy and is shaped in discussion with the chief executive and staff in the policy directorate. There is also input from the director of leadership in relation to leadership and cultural policy. The programme is also reviewed by the planning committee which is jointly chaired by the director of policy and the director of communications.

Detailed proposals for projects contained within the policy work programme are presented to and approved by the planning committee which considers any project that will result in a publication by the Fund. This includes Leadership Development projects that will result in a publication. The scope of projects is usually agreed internally although in some cases the views of external experts and stakeholders are sought. The board of trustees only becomes involved in agreeing the scope of projects in the case of major programmes.

Drafts of policy and leadership development reports that lead to publications go through peer review, both internally and externally. Usually this involves review by relevant directors and senior colleagues ahead of review by experts in the relevant topics from outside the Fund. Depending on the nature of the report, we may draw groups of stakeholders together to contribute to and comment on developing work. These might include health professionals, patients, carers or academics. The chief executive will review reports following internal and external peer review and before they enter the editing process. A similar though usually lighter review process is used for publications by partner organisations which are jointly branded with the Fund, eg Nuffield Trust or the Faculty of Medical Leadership and Management.

Accountability for the quality and independence of reports rests with the chief executive who works closely with the directors of policy, leadership development and communications in signing off reports ahead of publication. This includes accountability for the line the Fund takes on the topics covered by reports and more generally the Fund’s line in commenting on government policies. The board holds the chief executive accountable for the quality assurance process and the quality of reports and analysis.

Internal processes and discussions are robust and thorough, particularly on issues that are likely to be politically sensitive or where the Fund’s independence may be called into question. The chief executive and directors of policy, leadership development and communications will often be joined by other senior colleagues such as the chief economist in these discussions. The planning committee is used when appropriate to discuss our line on emerging issues.

Meetings may be organised at very short notice when the Fund is asked to respond to breaking news or government announcements in order to agree the line to take and the language to be used to protect the Fund’s independence and reputation. Even with these processes and safeguards, there is always a risk that comments may be misquoted or misrepresented. The positions taken by the Fund are recorded in a database to help ensure consistency.

The board of trustees holds the chief executive to account for assuring and maintaining the quality and independence of the Fund’s work. It is not involved in determining the Fund’s line on policy issues, though it may discuss the line the Fund has taken and offer views and advice to the chief executive. The board is not involved in the drafting of reports, although from time to time the views of individual board members are sought on reports in their areas of expertise. 

The Fund operates a ‘no surprises’ regime to ensure that the board is aware of forthcoming publications and the line taken, especially where the Fund’s views are likely to attract media interest. Where possible within the constraints of the publishing schedule, this includes briefing the Board ahead of statements on important issues, eg in relation to our position on the emerging financial crisis within the NHS. More often, the board is briefed through email updates and board papers.

The above process is intended to protect and enhance the Fund’s independence and reputation for producing high-quality reports based on evidence and experience. Regular discussions between the senior management team and the board help to ensure mutual understanding of the work programme and the pipeline of reports emerging from the Fund. These discussions also enable the board to be aware of the thinking of senior staff on major issues of interest to the Fund, both in relation to the policy programme and leadership development work.