Governor policy briefings and articles

The policy briefings below are to keep you informed of the wider NHS landscape and understand how policy changes will impact on your role as a governor.

No trust is an island: A briefing for governors on working collaboratively in health and care systems 

This briefing informs governors about how trusts are working collaboratively within health and care systems to make best use of collective resources and improve services for patients. This means focusing on the needs of a local population and overcoming barriers between hospitals, mental and physical health services, local authorities, primary care and the wider public health system, including schools and housing.

View the briefing online

Council of governors: your role in a crisis - a briefing for foundation trust governors

John Coutts, governance advisor at NHS Providers, explores what council of governors should do when their trust experiences a crisis. No one likes to envisage their trust featuring on the front page of the local paper, or even in the national press, for the wrong reasons. But unfortunately things can go wrong, even in organisations that usually have had a strong record of delivering high quality healthcare. So what should governors do in the event of a crisis? Firstly, the facts need to be established and investigation carried out which may take some time. Once the full picture is clear, the council of governors has a role to play in holding non-executive directors to account for what actions the board has taken following an incident. However, the council must resist the temptation to substitute its own judgement for that of the board. Councils should base their judgments on whether the actions the board has taken are reasonable and sufficient. 

Read the full briefing here

Place based planning - a briefing for foundation trust governors

Miriam Deakin, head of policy at NHS Providers, explores the move towards place based planning and what this will mean for trusts and governors. There has been a growing focus in recent years on a more ‘place based approach’ to delivering health and care, reflected in the national planning guidance for 2016/17, which was published in December 2015 and encourages local leaders to come together and plan for a five year period through new ‘sustainability and transformation plans’ (STPs). All trusts will now be working with their local partners to develop the five year STP, covering October 2016 to March 2021. Immediate considerations for trusts include the need to: invest in local relationships, understand the agreed ‘footprint’, conduct transparent planning and identify leadership capacity to implement STPs. Considerations for governors will include understanding your trust’s STP footprint and how this will impact existing plans, staying up to date on STP information and discussing with your trust how you can assist in this transition. 

Read the full briefing here

The state of healthcare and adult social care in England - a briefing for foundation trust governors

The Care Quality Commission’s (CQC) State of Care report 2014/15 provides a helpful external analysis of care quality across the sector. Overall, the majority of health and social care organisations have been rated as good or outstanding. Of the inspected trusts, 95% were rated good or outstanding for caring, however, 74% of NHS providers were rated inadequate or requires improvement for safety. There remains a need for all services to ensure a sustained focus on patient safety, underpinned by leadership, robust governance and a culture of learning and improvement. The important of leadership is also highlighted, with 94% of services which were rated as good or outstanding for leadership achieving an overall rating as good or outstanding.

As a governor, you may wish to suggest that your trust reflects on the examples of good practice highlighted within the report and on the areas for improvement which are emerging as national themes. Your trust’s board and its council of governors should be aware of the organisation’s latest CQC rating by, any forthcoming inspections, and any remaining actions for improvement identified in the last inspection. The trust may wish to use the information from its inspection, as well as other sources of quantitative and qualitative information from services, governors, patients and services users to ensure continual improvement in the quality of care. Further information on what the state of care report means for your trust and council of governors is available in the briefing on our website.

Read the full briefing here

New care models: accountability - a briefing for foundation trust governors

With greater integration between health and social care, patients can often feel they are being passed from pillar to post when receiving care from different providers. The NHS Five year forward view strategy created by NHS England promotes the creation of new care models to help smooth patient pathways and foster better collaboration between different service providers. An example of a new care model is a joint venture between foundation trusts and a consortium of GPs. Models such as this, raise the question: what is the new accountability relationship between governors and foundation trusts? While the legal duties of foundation trusts and governors will not change, in some circumstances councils of governors may have to adapt to these new structures in order to carry out their accountability role effectively. When a joint venture has its own board, this may limit the influence of a council of governors to hold them to account. However, in practice a foundation trust may be able to appoint some of its own board members to ensure governors still have oversight of its service provision. With all of the new care models, governors must remain clear on the distinction between their statutory duties and any broader responsibilities which are taken on. In summary, governors can add real value to new care model organisations by representing members and the public and extending their accountability role. 

Read the full article here

The NHS Five year forward view - a briefing for foundation trust governors

The NHS Five year forward view (5YFV) sets the strategic framework within which the English NHS will operate and develop in future years and is designed to ensure its future sustainability while managing the demands of an ageing population with changing healthcare needs. It was jointly published in October 2014 by NHS England, the Care Quality Commission, Monitor, the NHS Trust Development Authority, Health Education England and Public Health England and has garnered widespread support including, importantly, from the government. It identifies three ‘gaps’ which the NHS needs to focus on for the benefit of patients and service users, which cover three main areas: health and wellbeing; care and quality; and funding and efficiency. 

Read the full briefing here

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