Do Hospital Boards matter for better, safer, patient care?

Article


Mannion, R., Davies, H.T.O., Jacobs, R., Kasteridis, P., Millar, R. and Freeman, T. 2017. Do Hospital Boards matter for better, safer, patient care? Social Science & Medicine. 177, pp. 278-287. https://doi.org/10.1016/j.socscimed.2017.01.045
TypeArticle
TitleDo Hospital Boards matter for better, safer, patient care?
AuthorsMannion, R., Davies, H.T.O., Jacobs, R., Kasteridis, P., Millar, R. and Freeman, T.
Abstract

Manifest failings in healthcare quality and safety in many countries have focused attention on the role of hospital Boards. While a growing literature has drawn attention to the potential impacts of Board composition and Board processes, little work has yet been carried out to examine the influence of Board competencies. In this work, we first validate the structure of an established ‘Board competencies’ self-assessment instrument in the English NHS (the Board Self-Assessment Questionnaire, or BSAQ). This tool is then used to explore in English acute hospitals the relationships between (a) Board competencies and staff perceptions about how well their organisation deals with quality and safety issues; and (b) Board competencies and a raft of patient safety and quality measures at organisation level.
National survey data from 95 hospitals (334 Board members) confirmed the factor structure of the BSAQ, validating it for use in the English NHS. Moreover, better Board competencies were correlated in consistent ways with beneficial staff attitudes to the reporting and handling of quality and safety issues (using routinely collected data from the NHS National Staff Survey). However, relationships between Board competencies and aggregate outcomes for a variety of quality and safety measures showed largely inconsistent and non-significant relationships.
Overall, these data suggest that Boards may be able to impact on important staff perceptions. Further work is required to unpack the impact of Board attributes on organisational aggregate outcomes.

KeywordsHospital Boards; Board governance; Patient safety; Healthcare quality; Board competencies
LanguageEnglish
PublisherElsevier
JournalSocial Science & Medicine
ISSN0277-9536
Electronic1873-5347
Publication dates
Online24 Jan 2017
Print01 Mar 2017
Publication process dates
Deposited25 Jan 2017
Accepted22 Jan 2017
Submitted09 Dec 2015
Output statusPublished
Publisher's version
License
Accepted author manuscript
License
Copyright Statement

Crown Copyright © 2017 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Digital Object Identifier (DOI)https://doi.org/10.1016/j.socscimed.2017.01.045
Web of Science identifierWOS:000397552900032
Permalink -

https://repository.mdx.ac.uk/item/86w70

Download files

  • 28
    total views
  • 5
    total downloads
  • 3
    views this month
  • 1
    downloads this month

Export as

Related outputs

Self-surveillance practices of factory women migrant workers receiving SRH interventions in Malaysia: The effects of salience, gendered subjectivity and universalism
Freeman, T., Miles, L. and Ying, K. 2024. Self-surveillance practices of factory women migrant workers receiving SRH interventions in Malaysia: The effects of salience, gendered subjectivity and universalism. Economic and Industrial Democracy. https://doi.org/10.1177/0143831X231225098
Migrant workers navigating the Covid-19 pandemic in the UK: Resilience, reworking and resistance
Miles, L., Freeman, T., Polzin, A., Reitz, R. and Croucher, R. 2023. Migrant workers navigating the Covid-19 pandemic in the UK: Resilience, reworking and resistance. Economic and Industrial Democracy. https://doi.org/10.1177/0143831X231199874
A handbook to support the sexual and reproductive health needs of factory women migrant workers
Miles, L., Endut, N., Freeman, T., Ying, K., Lai, W. and Mat-Yasin, S. 2022. A handbook to support the sexual and reproductive health needs of factory women migrant workers. Pulau Pinang, Malaysia Unit for Research on Women and Gender (KANITA), Universiti Sains Malaysia.
Empowerment as a pre-requisite to managing and influencing health in the workplace: the sexual and reproductive health needs of factory women migrant workers in Malaysia
Miles, L., Freeman, T., Lai, W., Mat-Yasin, S. and Ying, K. 2022. Empowerment as a pre-requisite to managing and influencing health in the workplace: the sexual and reproductive health needs of factory women migrant workers in Malaysia. Economic and Industrial Democracy. 43 (4), pp. 1676-1698. https://doi.org/10.1177/0143831x211024725
Sexual and reproductive health (SRH) of women migrant workers in the ASEAN region: a systematic narrative review and synthesis
Freeman, T., Miles, L., Mat-Yasin, S., Ying, K. and Lai, W. 2021. Sexual and reproductive health (SRH) of women migrant workers in the ASEAN region: a systematic narrative review and synthesis. 19th ILERA World Congress: Making and Breaking Boundaries in Work and Employment Relations. Lund, Sweden [Online] 22 - 24 Jun 2021
At the limits of "capability": The sexual and reproductive health of women migrant workers in Malaysia
Freeman, T., Miles, L., Ying, K., Mat Yasin, S. and Lai, W. 2021. At the limits of "capability": The sexual and reproductive health of women migrant workers in Malaysia. Sociology of Health & Illness. 45 (5), pp. 947-970. https://doi.org/10.1111/1467-9566.13323
Meta-regulation meets deliberation: situating the governor within NHS foundation trust hospitals
Millar, R., Freeman, T., Mannion, R. and Davies, H. 2019. Meta-regulation meets deliberation: situating the governor within NHS foundation trust hospitals. Journal of Social Policy. 48 (3), pp. 595-613. https://doi.org/10.1017/S0047279418000739
Decentring patient safety governance: case studies of four English Foundation Trust Hospital Boards
Freeman, T., Millar, R., Mannion, R. and Davies, H. 2017. Decentring patient safety governance: case studies of four English Foundation Trust Hospital Boards. in: Bevir, M. and Waring, J. (ed.) Decentred Health Policy: Learning from British Experiences in Healthcare Governance London, UK Routledge. pp. 70-89
Effective board governance of safe care: a (theoretically underpinned) cross-sectioned examination of the breadth and depth of relationships through national quantitative surveys and in-depth qualitative case studies
Mannion, R., Freeman, T., Millar, R. and Davies, H. 2016. Effective board governance of safe care: a (theoretically underpinned) cross-sectioned examination of the breadth and depth of relationships through national quantitative surveys and in-depth qualitative case studies. Health Services and Delivery Research. 4 (4). https://doi.org/10.3310/hsdr04040
Enacting corporate governance of healthcare safety and quality: a dramaturgy of hospital boards in England
Freeman, T., Millar, R., Mannion, R. and Davies, H. 2016. Enacting corporate governance of healthcare safety and quality: a dramaturgy of hospital boards in England. Sociology of Health & Illness. 38 (2), pp. 233-251. https://doi.org/10.1111/1467-9566.12309
An adult social care compendium of approaches and tools for organisational change
Miller, R., Freeman, T., Davidson, D. and Glasby, J. 2015. An adult social care compendium of approaches and tools for organisational change. Birmingham, UK Birmingham University.
Ethics and spirituality in the workplace: the growing role of the business case in reforms
Freeman, T., Kunter, A., Douglas, C. and Roper, I. 2015. Ethics and spirituality in the workplace: the growing role of the business case in reforms. Human Resource Management International Digest. 23 (5), pp. 43-44. https://doi.org/10.1108/HRMID-05-2015-0092
Hospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence
Millar, R., Freeman, T. and Mannion, R. 2015. Hospital board oversight of quality and safety: a stakeholder analysis exploring the role of trust and intelligence. BMC Health Services Research. 15 (1). https://doi.org/10.1186/s12913-015-0771-x
Overseeing oversight: governance of quality and safety by hospital boards in the English NHS
Mannion, R., Davies, H., Freeman, T., Millar, R., Jacobs, R. and Kasteridis, P. 2015. Overseeing oversight: governance of quality and safety by hospital boards in the English NHS. Journal of Health Services Research & Policy. 20 (1 supp), pp. 9-16. https://doi.org/10.1177/1355819614558471
Hospital board oversight of patient safety: a narrative review & synthesis of recent empirical research
Millar, R., Mannion, R., Freeman, T. and Davies, H. 2013. Hospital board oversight of patient safety: a narrative review & synthesis of recent empirical research. The Milbank Quarterly. 91 (4), pp. 738-770. https://doi.org/10.1111/1468-0009.12032
Priority setting and rationing in health care: evidence from the English NHS
Robinson, S., Williams, I., Dickinson, H. and Freeman, T. 2012. Priority setting and rationing in health care: evidence from the English NHS. Social Science & Medicine. 75 (12), pp. 2386-2393. https://doi.org/10.1016/j.socscimed.2012.09.014
Comparing the content of leadership theories and managers' shared perceptions of effective leadership: a Q-method study of trainee managers in the English NHS
Freeman, T. 2013. Comparing the content of leadership theories and managers' shared perceptions of effective leadership: a Q-method study of trainee managers in the English NHS. Health Services Management Research. 26 (2-3), pp. 43-53. https://doi.org/10.1177/0951484813513245
Priority-setting and rationing in healthcare: evidence from the English experience
Robinson, S., Williams, I., Dickinson, H., Freeman, T. and Rumbold, B. 2012. Priority-setting and rationing in healthcare: evidence from the English experience. Social Science & Medicine. 75 (12), pp. 2386-2393. https://doi.org/10.1016/j.socscimed.2012.09.014
Structures and processes for priority-setting by health-care funders: a national survey of primary care trusts in England
Robinson, S., Dickinson, H., Freeman, T., Rumbold, B. and Williams, I. 2012. Structures and processes for priority-setting by health-care funders: a national survey of primary care trusts in England. Health Services Management Research. 25 (3), pp. 113-120. https://doi.org/10.1258/hsmr.2012.012007
Resource scarcity and priority-setting: from management to leadership in the rationing of health care?
Dickinson, H., Freeman, T., Robinson, S. and Williams, I. 2011. Resource scarcity and priority-setting: from management to leadership in the rationing of health care? Public Money & Management. 31 (5), pp. 363-370. https://doi.org/10.1080/09540962.2011.598352
Disinvestment in health— the challenges facing general practitioner (GP) commissioners
Robinson, S., Dickinson, H., Freeman, T. and Williams, I. 2011. Disinvestment in health— the challenges facing general practitioner (GP) commissioners. Public Money & Management. 31 (2), pp. 145-148. https://doi.org/10.1080/09540962.2011.560714
Reflections on leadership and place
Mabey, C. and Freeman, T. 2010. Reflections on leadership and place. Policy Studies. 31 (4), pp. 505-522. https://doi.org/10.1080/01442871003723465
Performing leadership: towards a new research agenda in leadership studies?
Peck, E., Freeman, T., Six, P. and Dickinson, H. 2009. Performing leadership: towards a new research agenda in leadership studies? Leadership. 5 (1), pp. 25-40. https://doi.org/10.1177/1742715008098308
Performing governance: A partnership board dramaturgy
Freeman, T. and Peck, E. 2007. Performing governance: A partnership board dramaturgy. Public Administration. 85 (4), pp. 907-929. https://doi.org/10.1111/j.1467-9299.2007.00683.x
'Best practice' in focus group research: Making sense of different views
Freeman, T. 2006. 'Best practice' in focus group research: Making sense of different views. Journal of Advanced Nursing. 56 (5), pp. 491-497. https://doi.org/10.1111/j.1365-2648.2006.04043.x
Evaluating partnerships: A case study of integrated specialist mental health services
Freeman, T. and Peck, E. 2006. Evaluating partnerships: A case study of integrated specialist mental health services. Health and Social Care in the Community. 14 (5), pp. 408-417. https://doi.org/10.1111/j.1365-2524.2006.00658.x
Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England
Freeman, T. and Walshe, K. 2004. Achieving progress through clinical governance? A national study of health care managers' perceptions in the NHS in England. Quality and Safety in Health Care. 13 (5), pp. 335-343. https://doi.org/10.1136/qshc.2002.005108
Measuring progress in clinical governance: Assessing the reliability and validity of the Clinical Governance Climate Questionnaire
Freeman, T. 2003. Measuring progress in clinical governance: Assessing the reliability and validity of the Clinical Governance Climate Questionnaire. Health Services Management Research. 16 (4), pp. 234-250. https://doi.org/10.1258/095148403322488937
Using performance indicators to improve health care quality in the public sector: A review of the literature
Freeman, T. 2002. Using performance indicators to improve health care quality in the public sector: A review of the literature. Health Services Management Research. 15 (2), pp. 126-137. https://doi.org/10.1258/0951484021912897
The external review of quality improvement in health care organizations: A qualitative study
Walshe, K., Wallace, L., Freeman, T., Latham, L. and Spurgeon, P. 2001. The external review of quality improvement in health care organizations: A qualitative study. International Journal for Quality in Health Care. 13 (5), pp. 367-374. https://doi.org/10.1093/intqhc/13.5.367
Organisational strategies for changing clinical practice: How trusts are meeting the challenges of clinical governance
Wallace, L.M., Freeman, T., Latham, L., Walshe, K. and Spurgeon, P. 2001. Organisational strategies for changing clinical practice: How trusts are meeting the challenges of clinical governance. Quality in Health Care. 10 (2), pp. 76-82. https://doi.org/10.1136/qhc.10.2.76
Clinical governance. Scope to improve
Walshe, K, Freeman, T, Latham, L, Spurgeon, P and Wallace, L 2000. Clinical governance. Scope to improve. Health Service Journal. 110 (5728), pp. 30-32.