Effective governance and accountability must not be risked in rush to STPs and new care models

07 July 2016

NHS Providers has a key role in supporting boards as they navigate challenging times in a difficult financial environment. As new care models are rolled out, providers will be looking at:

On 7 July, NHS Providers is holding its annual governance conference where it will welcome over 300 delegates to examine the issues and share solutions.  Chris Hopson will make an opening speech at the conference.

Our press statement is below:

For immediate release: 7 July 2016

Effective governance and accountability must not be risked in rush to STPs and new care models

NHS leaders were today warned they risk damaging effective governance and accountability as the health service moves from a policy framework based on individual institutions to one focused on local integrated care systems.


The warning comes from NHS Providers which today publishes a report into the governance and accountability arrangements of the new care models that have emerged from NHS England’s Five Year Forward View, as well as the sustainability and transformation plans (STPs) that are being developed by local health economies across England. The report is published on the day of a major conference that NHS Providers is hosting on the theme of corporate governance.


Speaking at the conference, NHS Providers chief executive Chris Hopson warned that the understandable drive to more integrated care systems which span providers, commissioners and primary and social care must not come at the expense of good governance and proper accountability. 

 He said: “We understand the desire to move to new integrated models of care and more of a local system focus. But we are pursuing this at high speed and there are many risks. So far there has been little or no consideration of the implications for accountability and governance of provider trusts and other parts of the system that have traditionally operated as individual institutions.

 “If we are to move to new care models, adopt new integrated organisational forms and deliver services effectively across a wider geographic footprint, then we have to ensure the governance of service delivery and the accountability for that service delivery remain robust and effective. This means maintaining our investment in good corporate governance by organisations, but developing a more robust approach to governance between organisations and being clearer on lines of accountability at the local system level.

 “And although the current narrative emerging from the centre sometimes implies that we are moving from an individual institutional focus to a local system focus, the reality is that we need both. It’s not an either/or. We have to find ways of making governance and accountability for individual institutions and local systems complementary, not mutually exclusive.

 “Some in the centre will think that raising these issues is being pedantic, legalistic or is a way of blocking change. It isn’t. Good governance and clear accountability allow risk to be managed and mitigated. They need to be developed thoughtfully at times of peace to enable us to manage effectively in times of trouble.”

 Examples of key questions about governance and accountability in these emerging structures that need urgent answers include:


Some of these key issues are explored in a new report published today by NHS Providers and Hempsons: New care models: lessons learned so far and tips for moving forward. This guide outlines lessons learned on governance and accountability from the new care models so far and gives tips to help other new care models. Key messages from the report include:


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