From Ward to Board

In recent years, the boards that run NHS organisations have tended to focus on financial and performance measures rather than on the quality of clinical care. But health policy has changed dramatically, with Lord Darzi’s 2008 NHS Next Stage Review citing improving the quality of care as ‘the basis of everything we do in the NHS’. The business of caring is now just as important as balancing the books.

The post of nurse executive (or nursing director) was established alongside the first wave of NHS trusts in 1991. Nurse executives are well placed to improve the business of caring by helping boards not just to understand the quality of care patients receive on the wards, but to make the right decisions as to how to improve that care.

In 2007 the Burdett Trust commissioned The King’s Fund to develop an intensive programme of work to support executive nurses and NHS boards to ‘bring the ward to the board’. The focus was firmly on reviewing clinical quality, and putting patients and how they experience health care at the heart of an organisation’s work. 

The report from the first phase of the programme, From Ward to Board, sets out the key questions and findings from the first phase of the programme identifying good practice that can be easily replicated. The conclusions pull out the key areas that boards need to build on (such as devoting sufficient agenda time to discussions about quality), as well as the key skills and qualities nurse executives need to fulfil their role effectively.