Event insights: Beyond councils of governors - rethinking public accountability

Foundation trusts have historically used Councils of Governors as their statutory link to members and the public, while non foundation trusts and system partners rely on alternative accountability mechanisms. With government proposals signalling a potential removal of the requirement for councils of governors, boards are increasingly considering how they remain accountable, legitimate and responsive to the patients and communities they serve.

This interactive online peer learning event explored how NHS boards can strengthen accountability in a changing governance landscape. Delegates examined practical alternatives to traditional structures, including the role of lived experience and patient safety partnerships, and reflected on how boards can embed meaningful public and patient voice into decision-making.

The session covered

Leadership in action 

David Gilbert, patient leadership expert at InHealth Associates, shared his experience as the NHS’s first patient director and explored how lived experience leadership can be embedded within governance structures. He reflected on the opportunities and challenges of strengthening accountability through patient voice. 

Participation and coproduction 

Alison Kirk from Leicestershire Partnership NHS Trust outlined how this approach informed the trust’s model for participation and coproduction, highlighting how it supports accountability and influence while recognising areas for development. 

Facilitated peer learning discussions

Delegates engaged in breakout conversations to share perspectives on alternative accountability mechanisms beyond Councils of Governors. Discussions explored practical approaches to maintaining transparency, legitimacy and patient influence at board level.