What is Governance
Systems and Processes
The Board and its committees
Review of EHT Board Assurance Framework (BAF)
Clinical and non clinical components of integrated Governance
Appendix 1 – Key Governance reports
Appendix 2 – Trust Board and the organisational objectives for EHT
The modern NHS Board was established with the first NHS trust in 1991, introducing the concept of corporate responsibility whereby executive and non-executive directors shared responsibility for the Board’s decisions. NHS boards have a duty to ensure that their organisation delivers healthcare within a system of effective controls and the government’s objectives for the NHS. Chief executives are personally accountable for the quality of clinical care provided by their trusts.
Traditionally governance responsibilities have developed through a number of strands all evolving separately, Integrated Governance is a means to create greater focus, capacity and capability for Boards. By adopting the four characteristic of effective boards, it allows directors to work more corporately as a team, to challenge Board agendas, deliver objectives and to govern effectively.
All Boards need systems of reporting and monitoring that keep them informed of the progress of their objectives, the development and assessment of risks and issues that threaten the achievement of these. In essence Boards need to assure themselves that the trust is well managed, providing safe and appropriate care and is a place where patients would want to be treated.
Since April 2009, the single regulator for Health and Social care for all health services has be the Care Quality Commission. The move to new registration standards and the need to publish care quality accounts will mean that trusts have to review what assurances they need and from whom they commission them. The move to a commissioning driven service which devolve power to local doctors and nurses to improve patient care and align clinical and financial responsibilities, will mean that governance arrangements will need to evolve further to ensure that questions of clinical quality are integrated into mainstream processes.
This essay explores the systems and processes which health bodies use to direct and control their function; specifying best practice governance arrangements as well as the barriers to achieving truly integrated governance within and across partner organisations. What is Governance
Governance can be simply described as: ‘the system by which organisations are directed and controlled’. In effect, governance is concerned with systems, processes, controls, openness, integrity and accountability in the decision making processes of an organisation.
The following elements of good governance are derived from national, international and private sector good practice and are applicable to NHS organisations.
Clarity of Role - everyone knows who is responsible for what and who does it •
Accountability - there are clear lines of accountability for everyone and every decision taken both internally and externally •
Transparency and Integrity - decision making is clear, honest and open •
Rigorous Scrutiny - decisions are subjected to fair and robust challenge and experts are challenged •
Wide Participation - different views and perspectives are encouraged and nurtured. When appropriate, independent advice is sought •
Relevant Timely and Accurate Information - information is used effectively for both performance management and improvement •
Progressive Development - systems and processes are continually reviewed and improved. Lessons are learned from within and outside the organisation. Complacency is challenged
Integrated governance seeks to ensure that decision-making is informed by intelligent information...
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