Good Governance Handbook - HQIP

corporate governance 11 . The Care Quality Commission (CQC) use Quality Risk Profiles
which have been developed for all NHS organisations as a way of determining when
and what to base their inspection programme on.
A recent Airmic publication, written by Cass Business School, 12 identified seven broad
areas of risk that have traditionally been beyond the scope of risk management. The
research identified key lessons associated with the failure to prevent significant crises
and thereafter manage the consequences. The failures that gave rise to each crisis
were analysed and seven key issues emerged:
• board skills and inability of Non Executive Directors (NED)members to exercise
control
• blindness to inherent risks, such as risks to the business model or reputation
• inadequate leadership on ethos and culture
• defective internal communication and information flow
• organisational complexity and change
• inappropriate incentives, both implicit and explicit
• ‘Glass Ceiling’ effects that prevent risk managers from addressing risks
emanating from top echelons.
3.4 The challenge for governance today
All of the above adds up to a new and very different challenge to NHS and other
healthcare boards in the coming years. We are moving away from a spoon-fed,
prescribed model of leadership and governance to one where boards will need to
craft their own arrangements, based on good governance principles and established
better practice. Boards will need to ensure that they are in a state of continual
preparedness for an ever-changing world, where significant demands are placed on
their organisations and budgets.
Additionally, as CCG boards and HWBs develop many individuals new to board
governance roles are entering the scene in critical roles, controlling complex,
important organisations. And last but by no means least, organisations need to
respond to the current crisis in credibility that safety and quality issues are identified
and managed at board level. This amounts to a manifesto for a better understanding
of what good governance is, what it can deliver and what the foundation principles
are, upon which, good governance practice can be developed.
11 Financial Services Authority, Effective Corporate Governance: Significant influence controlled
functions and the Walker Review, September 2010
12 Airmic, Roads to Ruin A Study of Major Risk Events: Their origins, impact and implications, July 2011
www.good-governance.org.uk 8