Oxford Health NHS Foundation Trust Quality governance review A final report from the Good Governance Institute December 2022

That the trust develops a quality strategy that defines its ambitions around all aspects of the QMS including the enablers. This should include: a. the committee structure to support the ambitions under each of the components of the QMS b. the data flows to allow an understanding of what is going well (or not) and to ensure that the right data is at the right level (team/directorate/QAC/board), and it is of a manageable and usable amount c. that the ambition around the enablers (leadership behaviours, coproduction, and equity) are identified and agreed across the trust board and sufficient resource identified to achieve the ambition d. the emerging quality assurance programme continues to refine and develop its approach particularly around the development of heat maps and peer review; these have real potential but need to be developed and implemented in a structured purposeful way that ensures fidelity to any chosen methodology e. the extent that the board and the trust want to utilise improvement science to solve some of its most intractable problems.

As the board matures, we recommend that it asserts its right to own its own agenda including its role and position in the changing NHS. To do this it should set out its own narrative of what it values and prioritises. It can then rebalance its agendas so that it spends the majority of its time on strategy and looking forward while maintaining adequate control of performance assurance.

The executive team should consider what it means to be a director of a unitary board and review how to contribute beyond their own portfolio.

To ensure that the trust’s strategy is as effective as it can be the trust should: a. engage with staff and other partners to socialise the strategy so that there is widespread understanding of the trust’s vision, values and strategic objectives b. revisit the reporting of performance in delivering the strategic objectives, and in demonstrating how these objectives link to improvement in the trust at a day-to-day operational level.

The trust board should spend time reflecting on its role in the ICS, and how it can maximise its impact so as to deliver the benefits of partnership working.

The reporting and monitoring to the board of the different initiatives which are being driven forward need to be developed and formalised. This includes actions taken in relation to culture, EDI, insight from staff and service user experience.

Meeting improvements: a. review agenda structures to give a more strategic focus to part of each committee meeting with the focus driven through the board assurance framework risks ascribed to each committee; it should then form the backbone of the work of the committees b. ensure a standardised cover sheet is completed for all papers, which should be crisply written and only as long as they need to fulfil their brief c. committee chairs should report to the board using the 3As method – alert, assure, advise d. there should be a short role specification for the senior independent director e. three non-executive directors should sit on each committee and once its role is reconfirmed, the membership of the audit committee should be revised to be fully independent.

Three non-executive directors should sit on each board committee. The role of the audit committee should be reconfirmed, and its membership should be revised to be fully independent.

Any new group should be required to pass the nine questions test before being set up and then should be reviewed at months 1 and 3.

By making research and innovation a strategic priority the board should signal its support and enthusiasm for this topic.

It should also ensure that as much airtime is given to spreading news about activities and achievements either on its own account or as a part of Oxford Academic Health Partners and other research bodies.