WIREDGOV

Monitor recommends that all NHS Foundation Trusts should obtain every three years an external review of the way they are run by their board.

Monitor authorises foundation trusts on the basis that they are well-led. Once a trust has been issued with a licence, the board then becomes responsible for maintaining this standard of corporate oversight.

Problems with the way trusts are led are on the increase, with one in four trusts having been subject to regulatory action due to governance failings since 2008. New guidance, out for consultation today, provides trusts with expert advice on the structure and steps required to enable them to conduct an effective review of their governance.

Monitor’s experience suggests that when governance problems do arise at a trust, it is usually several years after it has achieved foundation trust status.

Key proposals set out in the new guidance include:

• Board reviews should be conducted every three years - this is consistent with good corporate practice;
• Reviews should be robust, in-depth and tailored to cover the specific circumstances of a board; and
• Independent reviewers should carry out these reviews to ensure objectivity and provide maximum assurance. 

Monitor's guidance incorporates and builds on its existing ‘quality governance’ framework that is used widely by NHS providers. The four elements of the framework are: strategy and planning; capability and culture; process and structures and measurement.

Toby Lambert, Director Strategy and Policy at Monitor, said:

"Good governance enables trusts to meet the challenges they face, while providing patients with the high quality care they deserve.

"We believe regular effective governance reviews are a vital tool in showing that a trust is well-led, and whether any of their practices or capabilities need to improve.

"Our guidance will help trust boards successfully conduct these reviews, so that they can gain the maximum benefit from the process and support the provision of sustainable high quality services for patients."

Notes to editors:

• For further information please contact the Press Office on press.office@monitor.gov.uk or 020 3747 0800
• Copies of the Governance and Capability Reviews consultation is available here
• Monitor is the sector regulator of NHS-funded health care services. Under the Health and Social Care Act 2012 its main duty is to protect and promote the interests of people who use them.
• Information about Monitor's role can be found here
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