Ensuring common standards of competence and compliance

Accepted.
The Care Quality Commission will be responsible for ensuring that all registered providers have appropriate and effective governance arrangements in place as part of its overall assessment of the health of the organisation. This will apply regardless of whether or not an organisation is a Foundation Trust.
One of the key questions that the Chief Inspector of Hospitals, will ask is whether or not an organisation is well-led. In addition, the NHS Trust Development Authority will be responsible for ensuring that NHS Trusts that do not have Foundation Trust status have effective governance arrangements in place. The approach used by the NHS Trust Development Authority is consistent with that used by Monitor, and both of these organisations along with the Care Quality Commission will continue to work closely to ensure that there is effective regulatory scrutiny of governance and compliance with appropriate standards. There will also be checks on quality governance by the NHS Trust Development Authority before referral to Monitor.

Since, 2009 the Care Quality Commission has been the independent regulator for health and adult social care services since 2009. The CQC will assess corporate governance arrangements as part of their Well-led Framework. The NHS Provider licence included a condition covering provider governance (FT4) that required organisations to meet specific standards as set by DHSC, Monitor (prior to its abolition and transfer of functions to NHS England), CQC or NHS England.

NHS England has additionally developed a Code of governance for NHS provider trusts (2023) that sets out the expectation that the board of directors to establish procedures that manage risk.

See response to recommendation 60, above.

The Care Act 2014 introduced a new set of fundamental standards, which will apply to all providers from April 2015. Under the Care Quality Commission’s new inspection regime lead by the chief inspectors of hospitals, adult social care, and general practice, every service and provider is ask five questions:
• Are they safe?
• Are they effective?
• Are they caring?
• Are they well led?
• Are they responsive to people’s needs? The Care Quality Commission consulted on its proposals on how organisations can meet the fundamental standards which include the fit and proper person test as part of the ‘well led’ domain. The consultation concluded in October 2014.

Fit and Proper Persons Test Regulations have been passed by Parliament and are in place in November 2014 for NHS organisations and from April 2015 for other organisations. The Care Quality Commission held a consultation between July and October 2014 setting out proposals on how organisations can meet the fit and proper person test.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that the Care Quality Commission would be responsible for ensuring that all registered providers and appropriate and effective governance arrangements when assessing the overall health of the organisation, regardless of whether or not it was a foundation trust. One of the questions it would ask during an inspection is whether or not an organisation was well-led. The NHS Trust Development Authority was to be responsible for ensuring that NHS Trusts had effective governance arrangements in place.