Think Autism strategy: governance refresh

The way that the Department of Health and Social Care and other organisations monitor the progress of the autism strategy has been updated.  Click here to read further.

Updated guidance on the fit and proper person requirement

The CQC has updated its guidance on Regulation 5 - the fit and proper persons requirement for directors.

This is to reflect the changes outlined in our recent ‘next phase of regulation’ consultation. The guidance provides a more detailed explanation of what CQC interprets as serious mismanagement and serious misconduct. It also offers greater clarity about the obligations and responsibilities of those holding director roles.

Learning from improvement: special measures for quality

Four years after the introduction of special measures, NHS Improvement reviewed the experience of trusts that exited the process so we can better understand why they entered special measures, what actions they took and how they implemented change to improve.

Cowper’s Cut: ‘The Tragedy Of The Commons’ meets ‘Only Connect’

With things looking quite dark in the NHS, we can only hope that the forthcoming Budget will improve the situation even as we try to put a quart of healthcare demand into a pint pot of healthcare resource, says Andy Cowper

‘The tragedy of the commons’ was a concept and phrase proposed in an 1833 essay by economist William Forster Lloyd. He proposed (in the context of unlimited animal grazing on common land) that within a shared resource system, self interested individual users may act against the common good by depleting or spoiling that resource through the totality of many such selfish individuals’ actions.


To obtain this article copy and paste the post into an email and send to: libraryw@uhcw.nhs.uk

New guidance on managing conflicts of interest in the NHS

On 9 February 2017, NHS England issued new guidance on managing conflicts of interest in the NHS. This guidance:

• introduces common principles and rules for managing conflicts of interest
• provides simple advice to staff and organisations about what to do in common situations
• supports good judgement about how interests should be approached and managed.

See Conflicts of Interest in the NHS – Guidance for staff and organisations

The guidance came into force on 1 June 2017 and is applicable to the following NHS organisations:

• Clinical Commissioning Groups (‘CCGs’)
• NHS Trusts and NHS Foundation Trusts – which include secondary care trusts, mental health trusts, community trusts, and ambulance trusts
• NHS England (through our Standards of Business Conduct).

This guidance supersedes and extinguishes the Standards of Business Conduct for NHS staff (HSG(93)5).

To make implementation easier a model policy which includes the content of the guidance has been released. Organisations can adopt this policy or use parts of it to update their current policies and procedures.

See also Managing conflicts of interest in the NHS – questions and answers

Sustainability and transformation partnerships: developing robust governance arrangements

This briefing from the HFMA includes a diagnostic tool to assess the status of governance arrangements arising from ‘at scale’ working. Completing the tool will provide a basis for discussion by the board/ governing body and/ or audit committee of an NHS body when seeking assurance about developing governance arrangements.

Are services well-led? Continuous improvement

Sets out how providers should carry out developmental reviews of their leadership and governance using the well-led framework.

• Developmental reviews of leadership and governance using the well-led framework: guidance for NHS trusts and NHS foundation trusts
• Well-led framework supplementary guide

Scrutiny: the new assurance? A good governance discussion document

As collaboration and partnership working need to become more streamlined, more strategic and more effective, organisations spending public monies should be constantly redefining their roles and responsibilities, searching for constant improvement. 

This paper from the Good Governance Institute looks at scrutiny across a number of organisations, as all four home nations are seeking better outcomes by the alignment of health, social care and other funders and providers.

Radiofrequency treatment for haemorrhoids [IPG589]

Radiofrequency treatment for haemorrhoids Current evidence on the safety and efficacy of radiofrequency treatment for haemorrhoids is inadequate in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.

Clinicians wishing to do radiofrequency treatment for haemorrhoids should: Inform the clinical governance leads in their NHS trusts.

Ensure that patients understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.

Audit and review clinical outcomes of all patients having radiofrequency treatment for haemorrhoids (see section 7.1).

Well-led framework

As part of NHS Improvement's commitment to simplifying its regulatory approaches, they've worked closely with the the Care Quality Commission (CQC) to bring together their respective approaches resulting a fully joint well-led framework structured around eight key lines of enquiry.

The new framework maintains focus on strong integrated governance and leadership across quality, finance and operations, and in line with the changing operating environment, increases emphasis on organisational culture, improvement and system working.

CCG lay members, non-executive directors and STP governance and engagement

This report, published in partnership with NHS England, summarises the discussions at four regional workshops which focused on the role of lay members and non-executive directors in STPs. 

It discusses the importance of governance and accountability and developing working relationships across STP footprints. It also captures a number of case studies highlighting where there has been good practice in involving lay members and non-executive directors across STPs

What are STPs and why do they matter?

Chris Ham, CEO of the King's Fund has written this article which examines STPs and how their success is important to the future shape and well-being of the NHS. It suggests STPs need to strengthen their leadership and governance and ensure they have the capacity and capability to implement their proposals; NHS England and NHS Improvement need to work together to oversee STPs; and the scope of STPs needs to be narrowed to focus on the most important priorities in each area of England

New Ophthalmic Guidance available

The following guidance has been updated by the Royal College of Ophthalmology:

• Ophthalmic Imaging
• Managing an outbreak of postoperative endophthalmitis
• Ophthalmic Pathology
• Quality safety and clinical governance in ophthalmology: An overview
• Clinical Audit and Clinical Effectiveness in Ophthalmology
• Standards for Virtual Clinics in Glaucoma Care in the NHS Hospital Eye Service 

Single Oversight Framework:segmentation

Under the Single Oversight Framework (SOF), which is designed to help NHS providers attain, and maintain, Care Quality Commission ratings of ‘Good’ or ‘Outstanding’, NHS Improvement has segmented providers based on the level of support each provider needs.

UHCW is in Segment 3 which covers providers receiving mandated support for significant concerns: there is actual or suspected breach of licence, and a Regional Support Group has agreed to seek formal undertakings from the provider or the Provider Regulation Committee has agreed to impose regulatory requirements.

Oversight of new care models: your questions answered

The new care models programme is delivering a key element of the Five Year Forward View and we're working to support innovative change.

This document tackles questions we've received on NHS Improvement's oversight and outlines what other guidance and support we can give.  It has now been updated.

Annual Governance Statement requirements for NHS trusts

NHS Improvement has written to NHS trusts confirming requirements for Annual Governance Statements for 2016/17. There are no changes compared to the detailed requirements for last year. This letter also provides an update on arrangements for going concern.

Managing conflicts of interest in the NHS

NHS England has issued new guidance on managing conflicts of interest in the NHS. It:

• introduces common principles and rules for managing conflicts of interest
• provides simple advice to staff and organisations about what to do in common situations
• supports good judgement about how interests should be approached and manage

Consultation on use of resources and well-led assessments

This consultation from NHS Improvement contains proposals for how NHS trusts and foundation trusts can make effective use of resources, leadership and governance enabling them to provide sustainable high quality services for patients. The deadline for responses is 14 February 2017.

STP checklist for governance and engagement

Sustainability and Transformation Plans (STPs) are the latest mechanism to drive system-wide collaboration and planning and bring with them an important opportunity to improve the way the whole system works together to deliver high quality and sustainable services across a place. Since STPs do not change the statutory responsibilities of individual organisations they raise important questions for how governance and engagement will be managed to support collective decision-making.

This checklist is for CCG lay members, provider non-executive directors (NEDs), councillors, local Healthwatch organisations, the voluntary sector, and other key community partners. It provides a series of questions that can be asked locally and within boards to support effective dialogue and decision-making within ‘STP footprints’.

Development and implementation of non-medical practitioners in acute care

Br J Nurs. 2016 Nov 10;25(20):1129-1134.

The purpose of this article is to discuss the evolving workforce required to deliver quality healthcare in NHS acute care settings within the UK. The development and implementation of non-medical practitioner (NMP) roles, such as advanced clinical practitioners, surgical care practitioners, surgical first assistants, physician associates and physician assistants in anaesthesia are discussed in relation to training, regulation, governance and evaluation in clinical practice.

UHCW Research: J. Abraham