An NHS board's purpose is to set strategy, steward risk and resources, and hold the executive to account so populations get measurably better outcomes. Yet the gap between purpose and performance is widening: information overload, rear-view metrics, strategies stuck in aspiration, delayed decisions.
The side-effect is process-driven governance rather than delivery. Boards receive data but lack the decision frameworks to act on it. The CQC Well-Led framework assesses exactly this capability, and most boards know they could do better.