Good Governance Handbook - HQIP

5. Types of Governance
5.1 Mechanics of Governance
The general approach for unitary boards is to adopt the UK Corporate Governance
code (previously known as the Combined Code) 15 on the basis of the Cadbury,
Greenbury and Higgs reports. 16,17,18
The main principle of the code is that every institution should be headed by an
effective board, which is collectively responsible for the success of the organisation.
The board’s role is to provide leadership of the organisation within a framework of
prudent and effective controls which enables risk to be assessed and managed.
The board should operate in the round focusing on the business of the organisation
by:
• constructive challenge and shaping proposals on strategy
• scrutinising the performance of management in meeting agreed goals and
objectives
• monitoring the reporting of performance
• satisfying themselves that services are safe and cost effective; on the integrity
of financial information and that controls and systems of risk management are
robust and defensible.
There should be just one governance; the use of qualifying adjectives is unhelpful and
perpetuates or encourages silos of governance however it is important for boards to
understand what is meant by regulators and others introducing terms such as Quality,
Clinical, Information and Research Governance especially where compliance is
expected or required. It is for the board to seek to align and integrate these
components and demonstrate grip over them all.
5.2 Quality and Clinical Governance
Everyone who uses the NHS expects to receive care of the highest standard. “Quality
Governance: The duty of each NHS body to put and keep in place arrangements for
the purpose of monitoring and improving the quality of health care provided by and
for that body” is a legal requirement. 19
From 1997 and in part in response to the Bristol Heart Inquiry 20 this ambition has
been supported by the concept of Clinical Governance:
15 Financial Reporting Council, The UK Corporate Governance Code, June 2010
16 Cadbury report, Financial Aspects of Corporate Governance, 1992
17 Greenbury report, Directors’ Remuneration, 1995
18 Higgs Report, Review of the role and effectiveness of non-executive directors, 2003
19 Health and Social Care (Community Health and Standards) Act 2003
20 The Bristol Royal Infirmary Inquiry, July 2001
www.good-governance.org.uk 18