Governance
Recommendations related to governance
Tag overview
recommendation across 16 inquiries
Across 16 inquiries
Tagged Recommendations
Uniform policy for obtaining technical advice
This issue was highlighted in the Grant Thornton report where similar recommendations are made to what is set out above. NHSL has taken steps to address the issue. However, it …
Documentation of technical adviser advice
I accordingly recommend that a similar procedure should be considered when technical advisers (particularly engineers) are providing specific technical advice in relation to a project such as the RHCYP and …
Simplify Emergency Preparedness Structures
The governments of the UK, Scotland, Wales and Northern Ireland should each simplify and reduce the number of structures with responsibility for preparing for and building resilience to whole-system civil …
Transparency, Governance and Accountability in Emergencies
The UK government, Scottish Government, Welsh Government and Northern Ireland Executive should improve transparency, governance and accountability for procurement in an emergency. As a minimum, these improvements should include the …
Governance
The Inquiry recommends a programme of work by the Trust to: • Consolidate governance improvements into a clear, prioritised programme overseen by the Board. This will ensure that the large …
NED champion for restraint reduction
HSCTs should appoint a non-executive director (NED) to act as a champion for restraint reduction, with a mandate to hold executive directors accountable for delivery.
Red-rated complaints shared with all NEDs
All complaints managed at corporate level and rated as red (using the red, amber and green (RAG) rating matrix) should be shared with all non-executive directors (NEDs) on the Board.
Holistic safeguarding governance review
HSCTs must review and improve governance of safeguarding to ensure that findings from different safeguarding investigations are considered holistically, synthesised and presented to the public part of a Board-level committee.
Executive Director of Clinical and Social Care Governance
There must be understanding of both individual untoward events but also (and more importantly) systems and trends. Creating and maintaining effective governance for complex systems requires specialist skills. While this …
NED with clinical governance expertise
NEDs should be selected for their expertise across a range of skills and at least one should have extensive experience of clinical or social care governance and be appointed as …
Triennial Board governance reviews
The DoH Permanent Secretary should commission triennial reviews of each Board’s collective performance in clinical and social care governance.
Audit committee implementation tracking
HSCT Board audit committees should consider all internal audit recommendations and require directorates to provide updates on implementation three months, six months and one year after the internal audit report …
Board member learning framework
The DoH should commission the HSC Leadership Centre to develop a learning framework for all Board members. All Trust Board directors should be required to undertake an examined course in …
Coastguard role in legislation
The role and functions of HM Coastguard should be set out in up-to-date legislation.
Board review governance - assurance not reassurance
We have illustrated throughout this Report how Maidstone and Tunbridge Wells NHS Trust relied on reassurance rather than assurance in monitoring its processes. The Board must review its governance structures …
Board oversight of licensed mortuary activity
Maidstone and Tunbridge Wells NHS Trust Board must have greater oversight of licensed activity in the mortuary. It must ensure that the Designated Individual is actively involved in reporting to …
Treat HTA compliance as Trust statutory responsibility
Maidstone and Tunbridge Wells NHS Trust should treat compliance with Human Tissue Authority standards as a statutory responsibility for the Trust, notwithstanding the fact that the formal responsibility under the …
Chief Nurse responsible for mortuary assurance
The Chief Nurse should be made explicitly responsible for assuring the Maidstone and Tunbridge Wells NHS Trust Board that mortuary management is delivered in such a way that it protects …
Security as corporate responsibility
Maidstone and Tunbridge Wells NHS Trust should treat security as a corporate not a local departmental responsibility.
Senior managers understand DI role and accountability
NHS trusts should ensure that senior managers, including the Chief Executive, have a clear understanding of the role of the Designated Individual, their lines of accountability, and the individual legal …
DI attendance at governance forums
NHS trusts should ensure that Designated Individuals attend the correct governance forums. This would allow them to escalate issues and risks, as well as reporting upwards when required.
Routine mortuary reporting to trust boards
All NHS trusts should establish a routine reporting system for matters relating to mortuaries and body stores. This reporting system should include the presentation of a formal report, by the …
Recommendations apply to temporary facilities
Trust boards should ensure that these recommendations and governance arrangements are applied to any temporary facilities used by trusts for the storage and care of deceased people.
Mortuaries treated as regulated activity in governance
Trust boards should take note of the fact that mortuary services are subject to statutory regulation and should be treated with equivalent regard to other regulated activities within trust governance …
Chief Nurse responsibility for deceased safeguarding
The remit of the Chief Nurse in NHS trusts should explicitly include executive responsibility for safeguarding the security and dignity of deceased people in NHS mortuaries and body stores.
Postgraduate training governance clarity
Postgraduate training providers using donors should ensure clarity in their governance and information-sharing, in particular where the providers are linked to both university and NHS settings. This clarity should include …
Local authority funding for security expedited
There must be a process to ensure that, where there is a requirement for funding to strengthen mortuary security, it is expedited and considered at the highest levels within the …
Local authority DI management and oversight review
There must be a review of the management and oversight arrangements for the mortuary service, taking into consideration who is appointed as the Designated Individual, their direct contact with the …
Local authority mortuary as regulated service
The mortuary service must be treated in the same way as other regulatory services within local authority reporting structures: The mortuary must be visible to scrutiny at the relevant statutory …
Local authority contractor governance assurance
Local authorities must ensure that the providers they contract or enter into agreements with have robust governance processes in place to oversee the services they provide. This should include Standard …
Security breaches reviewed by expert with action plans
All NHS trusts should take every breach of security in a mortuary or body store extremely seriously. Each security incident should be reviewed by a security expert who is able …
Community Advisory Body
A formal role be given within IBCA for an advisory body consisting of people infected and affected, covering a range of experience broadly representative of those groups, and (if those …
Trust/Board Action on Peer Reviews
That NHS Trusts and Health Boards should be required to deliberate on peer review findings and give favourable consideration to implementing the changes identified with a view to ensuring comprehensive, …
Arms Length Body Administration
I recommend that an Arms Length Body (ALB) should be set up to administer the compensation scheme, with guaranteed independence of judgement, chaired by a judge of High Court or …
Governance Structure
The governance structure for the delivery of a major project such as a light rail scheme should follow the published guidance and should ensure that there is clarity regarding the …
Risk Management Standards
The identification and management of risk should be an integral part of the governance of all major public-sector contracts in future. In identifying and managing risk the following principles should …
Independent school governance standards
The Department for Education and the Welsh Government should: amend the Independent School Standards to include the requirements that there is an effective system of governance, based on three principles …
Third Party Governance
Where other government bodies, such as Ofgem, or contractors or other third parties are involved in the implementation of a project, the 'home' Department must retain overall control and overall …
Business Case Approval Redesign
The processes within a Department for approving new expenditure and business cases including, where it forms part of that process, the role of Casework Committees, should be thoroughly re-designed to …
Flexible Expenditure Rules
Public expenditure rules should be sufficiently flexible so that false economies can be avoided. In order to deliver a policy objective, Departments should not be required to choose a more …
Sceptical Business Case Scrutiny
The Department of Finance's distinctive role in scrutinising business cases should be searching and sceptical, guarding against over-reliance on the assurances offered by the applicant Department.
Proactive DoF Monitoring
Particularly where a policy initiative is demand-led, novel, complex and/or likely to be lengthy, consideration should be given to increasing Department of Finance involvement from an early stage and on …
Ministerial Notification of Approval Conditions
Ministers should always be advised of any conditions attached to the approval of a policy or project by the Department of Finance. The Department of Finance should also require, and …
Departmental Finance Functions
The finance function within a Department should exert the necessary authority and capability to fulfil the requirements of 'Managing Public Money Northern Ireland', namely to retain a firm grasp of …
Budget Holder Financial Training
Civil servants who are responsible for holding and monitoring a budget should have to demonstrate core requirements in financial literacy and an understanding of how public spending operates, including what …
Value for Money Priority
Any imperative to spend a budget within a given timeframe should not be allowed to take precedence over how that budget is used and the longer term benefits and overall …
Governance Systems Review
The checks and balances within a Department designed to catch problems early failed over many years in DETI to identify certain of the risks of the RHI or their materialisation. …
HMT Communication Protocol
The protocol for relations with HMT, namely that the Northern Ireland Department of Finance must be the sole conduit of formal communication, should be reinforced and widely understood across the …
Ministerial Code Revision
The Code of Conduct issued to Northern Ireland Ministers in 2007 (contained within the Northern Ireland Ministerial Code 2006) should be revised and brought up to date reflecting the findings …
Independent sector provider responsibility
We recommend that the government addresses, as a matter of urgency, this gap in responsibility and liability.
Record Keeping Audit
Record keeping should be subject to rigorous, routine and regular audit.
Post-Mortem Limitation Authorisation
Authorisation for any limitation of a post-mortem examination should be signed by two doctors acting with the written and informed consent of the family.
Mortality Meeting Recording and Audit
The proceedings of mortality meetings should be digitally recorded, the recording securely archived and an annual audit made of proceedings and procedures.
Inquest Duties Protocol
Protocol should detail the duties and obligations of all healthcare employees in relation to healthcare related inquests.
Board Member Training on Patient Safety
Trust Chairs and Non-Executive Board Members should be trained to scrutinise the performance of Executive Directors particularly in relation to patient safety objectives.
Board Member Induction Training
All Trust Board Members should receive induction training in their statutory duties.
Executive Director Responsibilities
Trusts should appoint and train Executive Directors with specific responsibility for: (i) Issues of Candour. (ii) Child Healthcare. (iii) Learning from SAI related patient deaths.
Monitoring Candour Compliance
Trusts should monitor compliance and take disciplinary action against breach.
Board Meeting Minutes Preservation
Effective measures should be taken to ensure that minutes of board and committee meetings are preserved.
Children's Healthcare Governance
All Trust Boards should ensure that appropriate governance mechanisms are in place to assure the quality and safety of the healthcare services provided for children and young people.
Candour in Trust Communications
All Trust publications, media statements and press releases should comply with the requirement for candour and be monitored for accuracy by a nominated non-executive Director.
Independent Disciplinary Action
Notwithstanding referral to the GMC, or other professional body Trusts should treat breaches of professional codes and/or poor performance as disciplinary matters and deal with them independently of professional bodies.
Trust Compliance Officer
Trusts should appoint a compliance officer to ensure compliance with protocol and direction.
Board Awareness of SAI Reports
Trusts should ensure that all internal reports, reviews and related commentaries touching upon SAI related deaths within the Trust are brought to the immediate attention of every Board member.
Trust Board Review of IHRD Report
All Trust Boards should consider the findings and recommendations of this Report and where appropriate amend practice and procedure.
Leadership Development
The highest priority should be accorded the development and improvement of leadership skills at every level of the health service including both executive and non-executive Board members.
Continue governance systems work
The University Hospitals of Morecambe Bay NHS Foundation Trust should continue to prioritise the work commenced in response to the review of governance systems already carried out, including clinical governance, …
Clear nursing responsibility line
Health Boards should ensure that there is a clear and effective line of professional responsibility between the ward and the Board.
Local HAI Task Forces
Scottish Government should develop local Healthcare Associated Infection (HAI) Task Forces within each Health Board area.
ICM reports to CEO
Health Boards should ensure that the Infection Control Manager reports direct to the Chief Executive, or at least to an executive board member.
ICM Board HAI reporting
Health Boards should ensure that the Infection Control Manager is responsible for reporting to the Board on the state of healthcare associated infection in the organisation.
CDI reporting to CEO and Board
Health Boards should ensure that numbers and rates of CDI are reported through each level of the organisation up to the level of the Chief Executive and the Board. Reporting …
Regular IPC group meetings
Health Boards should ensure that infection prevention and control groups meet at regular intervals and that there is appropriate reporting upwards through the management structure.
IPC committee minutes reporting
Health Boards should ensure that the minutes of all meetings and reports from each infection prevention and control committee are reported to the level above in the hierarchy and include …
Lay representation on IPC committee
Health Boards should ensure that there is lay representation at Board infection prevention and control committee level in keeping with local policy on public involvement.
Priority attendance at IPC meetings
Health Boards should ensure that attendance by members of committees in the infection prevention and control structure is treated as a priority. Non-attendance should only be justified by illness or …
Reorganisation due diligence
In any major structural reorganisation in the NHS in Scotland a due diligence process including risk assessment should be undertaken by the Board or Boards responsible for all patient services …
Internal investigation independence
Health Boards should ensure that a non-executive Board member or a representative from internal audit takes part in an Internal Investigation of the kind instigated by NHSGGC.
IPC clinical governance meetings
Health Boards should ensure that infection prevention and control is explicitly considered at all clinical governance committee meetings from local level to Board level.
The nature of standards
In addition to the fundamental standards of service, the regulations should include generic requirements for a governance system designed to ensure compliance with fundamental standards, and the provision and publication …
The nature of standards
All the required elements of governance should be brought together into one comprehensive standard. This should require not only evidence of a working system but also a demonstration that it …
Health Education England
Health Education England should have a medically qualified director of medical education and a lay patient representative on its board.
Strengthening the nursing professional voice
The Royal College of Nursing should consider whether it should formally divide its "Royal College" functions and its employee representative/trade union functions between two bodies rather than behind internal "Chinese …
Strengthening the nursing professional voice
All healthcare providers and commissioning organisations should be required to have at least one executive director who is a registered nurse, and should be encouraged to consider recruiting nurses as …
Strengthening the nursing professional voice
Commissioning arrangements should require the boards of provider organisations to seek and record the advice of its nursing director on the impact on the quality of care and patient safety …
Ensuring common standards of competence and compliance
Consideration should be given to ensuring that there is regulatory oversight of the competence and compliance with appropriate standards by the boards of health service bodies which are not foundation …
Board accountability
Each provider organisation should have a board level member with responsibility for information.
Use of information about compliance by regulator from: Quality accounts
Trust Boards should provide, through quality accounts, and in a nationally consistent format, full and accurate information about their compliance with each standard which applies to them. To the extent …
Care Quality Commission independence strategy and culture
Where issues relating to regulatory action are discussed between the Care Quality Commission and other agencies, these should be properly recorded to avoid any suggestion of inappropriate interference in the …
Care Quality Commission independence strategy and culture
Patients, through their user group representatives, should be integrated into the structure of the Care Quality Commission. It should consider whether there is a place for a patients' consultative council …
Care Quality Commission independence strategy and culture
Consideration should be given to the introduction of a category of nominated board members from representatives of the professions, for example, the Academy of Medical Royal Colleges, a representative of …
Consolidation of regulatory functions
The Secretary of State should consider transferring the functions of regulating governance of healthcare providers and the fitness of persons to be directors, governors or equivalent persons from Monitor to …
Focus on compliance with fundamental standards
The assessment criteria for authorisation should include a requirement that applicants demonstrate their ability to consistently meet fundamental patient safety and quality standards at the same time as complying with …
Need for constructive working with other parts of the system
The Department of Health's regular performance reviews of Monitor (and the Care Quality Commission) should include an examination of its relationship with the Department of Health and whether the appropriate …
Enhancement of role of governors
The Council of Governors and the board of each foundation trust should together consider how best to enhance the ability of the council to assist in maintaining compliance with its …
Accountability of providers' directors
There should be a requirement that all directors of all bodies registered by the Care Quality Commission as well as Monitor for foundation trusts are, and remain, fit and proper …
Accountability of providers' directors
A finding that a person is not a fit and proper person on the grounds of serious misconduct or incompetence should be a circumstance added to the list of disqualifications …
Requirement of training of directors
A requirement should be imposed on foundation trusts to have in place an adequate programme for the training and continued development of directors.
Independent Board Governance
An independent self regulatory body should be governed by an independent Board. In order to ensure the independence of the body, the Chair and members of the Board must be …
Complaint Decision Responsibility
Decisions on complaints should be the ultimate responsibility of the Board, advised by complaints handling officials to whom appropriate delegations may be made.
Complaints Committee Composition
Serving editors should not be members of any Committee advising the Board on complaints and any such Committee should have a composition broadly reflecting that of the main Board, with …
Chair Appointment Panel
The appointment of the Chair of the Board should be made by an appointment panel. The selection of that panel must itself be conducted in an appropriately independent way and …
Recognition Body Role
The responsibility for recognition and certification of a regulator shall rest with a recognition body. In its capacity as the recognition body, it will not be involved in regulation of …
Appointment Panel Composition
The appointment panel: (a) should be appointed in an independent, fair and open way; (b) should contain a substantial majority of members who are demonstrably independent of the press; (c) …
Ofcom as Recognition Body
The role of recognition body, that is to say, to recognise and certify that any particular body satisfies (and, on review, continues to satisfy) the requirements set out in law …
Multiple Regulatory Bodies
It should be possible for the recognition body to recognise more than one regulatory body, should more than one seek recognition and meet the criteria, although this is not an …
Duty to Protect Press Freedom
In passing legislation to identify the legitimate requirements to be met by an independent regulator organised by the press, and to provide for a process of recognition and review of …
Board Appointment Independence
The appointment of the Board should also be an independent process, and the composition of the Board should include people with relevant expertise. The requirement for independence means that there …
Board Member Composition
The members of the Board should be appointed by the same appointment panel that appoints the Chair, together with the Chair (once appointed), and should: (a) be appointed by a …
Reconstitute ICO as Commission
The opportunity should be taken to consider amending the Data Protection Act 1998 formally to reconstitute the Information Commissioner's Office as an Information Commission, led by a Board of Commissioners …
Funding Settlement
Funding for the system should be settled in agreement between the industry and the Board, taking into account the cost of fulfilling the obligations of the regulator and the commercial …
ICO Organisation Review
The Information Commissioner's Office should take the opportunity to review its organisation and decision-making processes to ensure that large-scale issues, with both strategic and operational dimensions (including the relationship between …
Standards Code Responsibility
The standards code must ultimately be the responsibility of, and adopted by, the Board, advised by a Code Committee which may comprise both independent members of the Board and serving …
Internal Governance Processes
The Board should require, of those who subscribe, appropriate internal governance processes, transparency on what governance processes they have in place, and notice of any failures in compliance, together with …