Health trust boards are models of diversity

The problem with jobs on the board is that it is reminiscent of another phrase: jobs for the boys. And that is just how public appointments in the NHS are viewed by many women, disabled people and people from black and minority ethnic (BME) communities. So says Andrea Sutcliffe, chief executive of the Appointments Commission, which oversees recruitment for all public roles including the non-executive directors of NHS trusts and PCTs and is responsible for ensuring public bodies reach the government's 2009 diversity targets (see panel). "Our research shows that women who might have the right skills and experience do not apply, while in BME communities there is not as long a tradition of appointments as there is in other groups." Lynn Travis, for example, took early retirement from running her own PR business and assumed that boards would favour only high-powered business people until a friend recommended she join the board of Tameside and Glossop PCT in 2006. "As a non-executive you are the link with the community and you bring people's experiences to the board," she says. All NHS organisations have a trust board made up of executive directors who have a full-time job in the NHS and at least five paid non-executives. The latter typically work two days a month and are responsible for the organisation's performance. These highly demanding – albeit part-time – roles pay an annual £6,000 to £8,000. Sutcliffe is adamant that NHS board members need not only skills in finance or marketing, but must also represent their communities: "They are responsible for the stewardship of billions of pounds of tax payers' money, for services that touch people at their most vulnerable, and for thousands of staff in their organisations." Her strategy is to invite people to explore whether they might be a candidate for a public appointment. The commission runs workshops with groups such as Women Like Us and the Progressive Muslim Forum, plans sessions with disability charity Radar and works with employers, such as BT, to identify potential board members. Sutcliffe rejects suggestions that the price for diversity is quality of candidate. "We absolutely will continue to appoint on merit the best people to these jobs." Gideon Ben-Tovim, who chairs Liver­pool PCT, agrees. "There are plenty of people who have the governance skills, the commitment and the connections with the communities required to be really strong board members," he says. When Liverpool PCT was established in 2006, over 100 people applied for the non-executive posts thanks to a publicity drive and a history of public service in the region. The trust's board is now a nationally renowned model of gender and BME diversity. Ben-Tovim says: "We were able to select people with huge talent from a diverse range of backgrounds who were committed to the local population." The Appointments Commission strategy is beginning to work. For example, BME membership of boards is on target at 10-12%. However, Sutcliffe warns against complacency: "Boards are never going to represent every minority, but we need to consider whether they reflect and connect to the communities they serve." There has been less progress on disability, says Sutcliffe, although boards might be more diverse than they seem. Sutcliffe works to the Disabilities Discrimination Act definition that includes asthma and diabetes. "I am not sure of the extent to which people define themselves as disabled in these terms," she says. Sutcliffe wants to encourage younger people on to boards, a strategy that could help kill two birds with one stone: "We need to get experienced people with working lives who have different experiences of healthcare. What we have picked up is the younger we get, the more diverse we get." Appointments Commission Liverpool PCT Targets for diversity In June 2009, the Government Equalities Office and Cabinet Office set new targets and an action plan to increase diversity in public appointments by 2011: • Women: 50% (33.3% in 2008/9) • Disabled people: 14% (5% in 2008/9) • Asian, black and minority ethnic: 11% (less than 6% in 2008/9)