In the NHS the word ‘governance’ is often used, but is rarely defined. When we refer to governance we mean corporate governance: the system by which companies and other board-led organisations are directed and controlled.
The purpose of corporate governance is to provide ambitious, effective, prudent direction that leads to success over time. Corporate governance is the business of the board: setting strategy, supervising the work of the executive, setting and exemplifying corporate culture and giving account of the board’s actions to governors and stakeholders. Because it is ‘what the board does’, it is the business of every director whether they are an executive or non-executive; it is not the domain of ‘governance practitioners’. It is distinct from the day-to-day operational management of strategy implementation and management of risk carried out by the executives and their teams, but provides effective oversight of the work of the executives. So it is the methodology, put into practice that links the boardroom to the ward.
Foundations of good governance: The third edition ofThe foundations of good governance: a compendium of best practice produced by NHS Providers and DAC Beachcroft, provides practical support to those concerned with implementing the systems and processes that support good governance. We also recommend The healthy NHS board 2013: principles for good governance as a good source of well considered guidance.
Model election rules: In partnership with Lancashire Teaching Hospitals, we have developed model rules for governor elections.
High quality assurance: One of the key outcomes of good governance is high quality assurance: sufficient evidence that the risk to the right outcomes has been managed and controlled effectively and is likely to be controlled effectively in the future. Board assurance: a toolkit for health sector organisations, produced in partnership with Baker Tilley sets out an approach to board assurance that uses the board assurance framework as an effective boardroom tool.
Autonomy: We believe that strong autonomous boards are of central importance to the future of the NHS provider sector. Our publication We need to talk about boards makes the case for strong board leadership and local accountability to embed provider organisations into the communities they serve.
Legislative framework: The legislative framework underpinning the governance of NHS provider organisations is contained in the National Health Service Act 2006 as amended by the Health and Social Care Act 2012. The legislation is supplemented by the NHS foundation trust Code of Governance, which is based on the Financial Reporting Council’s (FRC) UK Corporate Governance Code. The FRC has also produced Guidance on board effectiveness which complements both the foundation trust and UK Codes. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 set out further requirements that boards must adhere to. Our guidance gives practical advice on how to comply with the regulations.
New care models: In many cases delivering new models of care will require organisations to work closely with others through a variety of arrangements ranging from transactions to the informal. Our joint publication with Hempsons New care models: governance between organisations addresses the distinctive issues of direction and control that can arise when organisations seek to provide services together or to set up a joint vehicle to do so. It provides some practical suggestions to deal with problems, which if not addressed may later prove to be intractable.
