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Understanding the relationship between NHS and Chairs and Chief Executives

Friday 31 July 2009

The nature of the relationship between the Chair and the Chief Executive can have a significant impact on an organisation but there has been little recent research on the quality of this relationship within NHS organisations.

In 2009 the NHS Institute for Innovation and Improvement commissioned OPM (Office for Public Management) to improve our knowledge and understanding of how these relationships work; what makes them effective and what can cause a relationship to go wrong. The research involved a review of the recent literature relating to Chair-Chief Executives relationships in the NHS and other sectors and qualitative interviews (face to face) with over 40 Chairs and Chief Executives from a full range of NHS organisations.

The research identified two key ways in which chairs and chief executives view their relationships; ‘co-action’ focused on interpersonal features and ‘counter action’ focused on tasks. It also identified behaviours judged as being important by participants for a successful relationship, factors that contribute to the breakdown of a relationship and the impact of the relationship on the organisation.

The study also considered how the NHS Institute can best support Chairs and Chief Executives in establishing and maintaining effective relationships. The report includes recommendations about the type of support that may be helpful to those looking to strengthen their relationships.