Board Effectiveness Review


Public Board



Report Title:

Board Annual Effectiveness Report 2022-23

Agenda Item:



Nicola Scrivings, Trust Chair

Linda Gove, Head of Corporate Governance

Lead Director:

Nicola Scrivings, Trust Chair


SR6: If we do not deliver sustainable regulatory compliance and develop positive relationships, we will have limited ability to deliver our strategy


Equality Impact Assessment

No negative impact identified




The Board is asked to review and approve the Board Annual Report and proposed Terms of Reference as part of the overall Board and Committee effectiveness reporting for 2022-2023.

Previously considered by:

Presented to the Board for ratification before being presented to the Audit and Risk Committee as part of the overall Board and Committee effectiveness reporting for 2022-2023.


The purpose of this Annual Report is to provide assurance that the Board has discharged its duties in accordance with its Terms of Reference and Establishment Order, completed its work plan for 2022-23 and to propose its key areas of work for 2023-24.

Executive Summary

This report covers the work the Board has undertaken at the meetings held during 2022-23. It seeks to provide reassurance on the work carried out and the assurances received and to demonstrate that it has operated within its Terms of Reference and Establishment Order. The report provides a retrospective view on its effectiveness for the past year, with a Trust Chair review and proposals for areas of focus moving forward.

The work of the Board 2022-23

1. Board Role

The purpose of the Board is to govern the Trust effectively and in doing so build public and stakeholder confidence that their health and healthcare is in safe hands and ensure that the Trust is providing safe, high-quality, patient-centred care.

2. Meetings, membership and attendance

During 2022-23 the Board met formally in public on seven occasions which is in line with its Terms of Reference.

11 May 2022

13 July 2022

14 September 2022

12 October 2022

9 November 2022

18 January 2022

15 March 2023

The Board is chaired by the Trust Chair and the voting members of the Board included all Non-Executive Directors, Chief Executive, Director of Nursing, Director of Finance, Chief Operating Officer and Director of People Services.

The Director of Strategy, Culture and Education, Director of Corporate Affairs and Performance, Medical Director and Director of Integration attend as non-voting executive directors. Other officers regularly attend the meetings to provide expertise and knowledge on the areas they are responsible for. These attendees do not count towards meeting membership as defined in the Terms of Reference.

3. Attendance

Nicola Scrivings 



Wendy Thomas 



Alison Wigg  



Tom Abell


Carolan Davidge 



Kevin Smith


Julie Thallon 



Marcus Bailey



Mrunal Sisodia 



Marika Stephenson


Neville Hounsome 



Melissa Dowdeswell


An Annual General Meeting was held 27 September 2022 at which the Annual Report and Accounts 2021-2022 were presented to the public and stakeholders.

4. Assurance

The Board receives assurance from several sources including:

  • written reports and documents
  • executive director and lead officer
  • subject matter experts who attend meetings as required
  • challenge by Committee members
  • service visits
  • talking to staff, networks and volunteers
  • External/Internal Audit reports
  • Regulatory inspections and reports
  • Board Assurance Framework

Assurance is provided to the Board via the below sub-committee flow.

  • Audit and Risk Committee
  • Nominations, Remuneration and Terms of Service Committee
  • Performance and Finance Committee
  • Quality Governance Committee
  • People Committee
  • Transformation and Change Committee
  • The Charitable Funds Committee acting as the corporate Trustee.
  • Executive Leadership Team
  • Executive Clinical Group

The Board scrutinises the assurance received from the reports and documents and can commission further information if there was a perceived or actual lack of assurance. The Board is assured that structures and workplans are in place to provide adequate oversight.

The Board maintains an action tracker that captures all actions and is a key element of assurance for the Committee.

The Board can also refer matters to other Board Committees as appropriate making clear the following three aspects: the matter being referred: the reason the Committee seeks referral: and how the outcome will be tracked.

The following referrals were made:

Release of improved guidance for patients on ambulance response times - assure – referral to Performance and Finance Committee

Flexible working policy – review of effectiveness – referral to People Committee

Civil Contingencies Act Compliance Action Plan – assure – referral to Performance and Finance Committee

The following referrals were received:

Review of Charity Strategy – review – referral from Charitable Funds Committee

5. Workplan and Agenda Management

The Annual Business Workplan 2022-2023 was approved by the Board at its May 2022 meeting.

The Trust Chair agrees the agenda for each meeting in conjunction with the executive leads and a full set of papers are circulated to Board members and attendees within agreed timescales.

Secretariat support is provided by the Corporate Governance Team in relation to agenda planning, minutes, managing action trackers and general meeting support.

The agenda follows a standard format:

  • Preliminary matters: apologies, declarations of interest, minutes, action tracker etc
  • Routine Reports: update reports, performance report etc
  • Concluding business: date of next meeting, items for referral

 6. The work of the Board during 2022-23 included consideration of the following:

Regular Business

Patient/Staff Story

CEO Report and Sustainability Updates

Trust Chair Report

Integrated Performance Report

Board Assurance Framework

System Integration and Partnerships Report

Regulatory Updates

Committee Assurance Reports

Freedom to Speak Up Updates

EDI Network Updates

Fit for the Future


Board Business



Independent Investigation into Staff Death

Clinical Strategy

Business Priorities and Plan

Operational Performance Improvement Plan

BME Survey Outcomes

Inclusivity Plan

Systems Improvement Schemes and Engagement

People Strategy

Workforce Plan

Leadership, Culture and Values

Communications and Engagement


Annual Compliance

Condition G6 and FT4 Self Certification

Modern Slavery Statement

WRES and WDES action plans

Gender Pay Gap Submission

Annual Staff Survey Report

Civil Contingency Act Compliance

Annual Reports

Annual Report and Accounts

Annual External Audit Management Letter

Quality Account

Clinical Audit Annual Summary

Legal Services Annual Report

Data Security Protection Toolkit Submission

Annual Research and Development Report

Risk Management Strategy and Policy

Safeguarding Annual Report

Infection Control and Prevention




Deep Dive

Bi-Annual Workforce Review

CESSATION research findings

 7. Board Assessment of Effectiveness

The effectiveness of the Board is monitored via the following governance activity:

  • Annual review of Terms of Reference
  • Board Annual Report
  • Annual Self-Assessment of Effectiveness
  • Annual Workplan
  • Feedback and reflection at the end of each meeting
  • 121 meeting feedback with members

 8. Annual Self-Assessment of Effectiveness

An annual self-assessment questionnaire was sent to Board members and regular attendees, the full responses can be found at Appendix 1. Questions focussed on three domains: leadership, structure and infrastructure and support. Most of the questions have a multiple-choice option with opportunity for ‘free text’ related to questions. Comments are included here for Board scrutiny and discussion.

I have noted unnecessary duplication of reporting between the Board and:

What are the critical business elements for the Board moving forward?

  • Ensure we have effective plans in place to improve the culture and operational performance.
  • Improve the papers even more to be more concise, with relevant plans, trajectories on outcomes, metrics, etc.
  • Clear line of sight on engagement / collaboration with system partners to deliver EEAST’s goals.
  • Preparing for 12 months’ time when the financial and performance challenges may be very different.
  • Clarification and socialisation of our vision for 5 years, and what that looks and feels like for all colleagues.

Please provide detail on what, if anything, you believe has improved in the Board function this year:

  • Quality of papers, greater trust across the board, clearer strategies.
  • The IPR has improved greatly.
  • The discussions are more open and more at a strategic level.
  • Data presented and triangulated into key themes for discussion.
  • Decisions/recommendations supported by better quality analysis.

Please provide detail on what requires further action:

  • Diversity of members.
  • Further progress towards working as a unitary board - executives flagging issues and concerns with NEDs earlier and engaging with them to coproduce ways forward.
  • More informal engagement between the executives and non-executives to build the level of trust to improve the discussions and continued development of cross-functional ownership.
  • Board to work more on vision, impact and key metrics.
  • Feedback from public around the Board activity could be useful to help further development.
  • IPR needs refocussing on what is the outcome and any gap between projected and desired outcomes.

What value does the Board add?

  • Leadership, challenge, support and recognition of what the Trust is trying to deliver to the service users in east of England.
  • Steering the organisation and ensure right decisions to move us from SOF4 and into an organisation we can be proud of with high quality care and happy staff.
  • Oversight, assurance and collective ownership of challenge and plans.
  • The visibility and conduct of the Board are critical.

 9. Terms of Reference Review

The Board has continued to develop over this reporting period and has built in several opportunities to assess its focus and approach including a full Board development programme, with input and support for external organisations.

The Board propose to maintain the purpose of the Board without amendment and further with no refinements to the provisions within the Terms of Reference. A tracked changes version is available at Appendix 2.

10. Key areas of focus for 2023/24

The Board Annual Workplan is attached as Appendix 3. The Board is asked to approve this as presented.

Trust Board Chairs Summary and Review

As outgoing Chair it has been a privilege to lead the Board for the last three years, and in particular to oversee the significant organisational improvements that are evident through the work of the Board detailed above all of which provides great foundations for future success.

We have made good progress on the underpinning framework for the organisation, simplifying our approach into 3 core strategies of People, Clinical and Sustainability. At Board we have also discussed and agreed significant investment in ambitious approaches for improvements that will improve our Culture, for example an overarching Inclusivity plan, new and improved career pathways for all employees and an expansion of our Well-being offer. At all times Board Members have used their skills and experience to ensure that EEAST secures a balance between patients, employees and our external stakeholders and continues its progress towards outstanding care. We enter the next year with a robust financial plan that provides appropriate resources to important areas of investment that will deliver better patient care and a great place to work.

Importantly whilst making the improvements as described, Board Members have also been involved in an extensive sequence of team and personal development activity, in order to equip us to function effectively as a Unitary Board. I would like to thank NHS Providers for their assistance and support which has helped us to become a better performing team.

The Board feedback is generally positive along the lines described above. However the feedback also identifies areas that require further improvement, for example eliminating the duplication between the Board and Transformation Committee and in partnership with all our stakeholders clarifying our long term vision and what that means for them. These points will be addressed in our Board plan for the coming year.

I would like to thank the Corporate Secretariat function for their professionalism during the year. The impact of their commitment underpins much of the positive progress cited by Board Members in the feedback, notably the improvements in data, analysis and overall coherent governance, which enable the Board to make good quality decisions.

I would also like to thank all Board Members for their energy, compassion and totally hard-work and commitment to always make EEAST a better place for patients, communities and all colleagues.

Nicola Scrivings

Trust Chair



Appendix 1

Appendix 2

Appendix 3

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