The Role Of The Board In Setting The Tone

In NHS the Board have a difficult and challenging role to fulfil.  They are the group of people who among other things:


  • Set the strategy
  • Develop the goals
  • Determine priorities
  • Deliver on a complex agenda
  • Manage internal and external relations
  • Inspire, motivate and get the best from people
  • Are accountable for what is and what is not delivered.

As we have seen from the recent Francis report on Mid Staffordshire NHS Foundation Trust, they also have a huge influence on behaviours and culture.

In most organisations people look to leaders to get an insight as to what is required and then tend to adapt so that they meet those requirements.

In the busy and demanding environment it is sometimes difficult to stop, stand back and consciously decide what behaviours and approach that we want from people.  At the same time getting that clarity allows everyone to be crystal clear about what is expected.

So what could Boards do that would help set the right tone?

Start By Taking Stock

Before you can determine what needs to change, you have to have a clear picture of where the organisation is at present.  You may well have considered culture in the past but what’s it like now.  While you can do surveys, often just getting out and discussing with people what it is really like can give you some great insights.

Define Your Goals

What is it that you want to have in the organisation in terms of the way people behave and interact?  What type of environment do you want people working in?  What kind of experience do you want service users to have?

Start Experimenting At The Very Top

If you want to improve listening, start by actively listening much more at the top of the organisation.  Make a point of seeing what works and does not work and whether your intentions are having the desired impact.

Keep Track

There is little or no benefit in seeing this as task and finish. If the tone that comes from the top is to be embedded in the organisation it almost has to be the way things are done around the organisation.  Have both formal and informal mechanisms for keeping track of how things are going.

Accept That It Will Be Challenging and Support People

Like any change or modification it is going to be challenging.  It’s vital that senior people support people through these challenges.

At the end of the day the culture, the environment and behaviours are all to a large extent influenced by the tone set at the top.

Goals and Achievements help organisations who are struggling to achieve great performance through people.  Learn more about our services and programmes here.