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About good governance

About good governance

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Our values-based consultancy helps our clients to improve their systems and processes for governance, assurance and accountability.

There is a lot of guidance about healthcare governance and this can be a term often used, but seldom applied to best effect. There are many different types of governance, and many different settings in which governance is used, for example, board governance, corporate governance, quality governance, project-based governance, clinical governance and operational governance.

Governance is often seen in bureaucratic terms rather than as a tool for safety,  effectiveness and efficiency – we firmly believe governance should be a ‘dynamic’  force which is enabling rather than a hindrance to the provision of good care. We  think there are certain key ingredients involved in good governance:

Good governance principally requires 6 key things:

  • An understanding of what it is you are governing – Is it a project or are you trying to introduce a new clinical governance framework or accountability framework with your partners? All of these need a different focus and dare say it, a different skill set. You also need a deep understanding of the services and staff that are involved in the governance you are trying to address.
  • Clarity on what you are trying to achieve – You should always line up the governance behind a ‘plan’ whether that be a strategy and objective or an action. Outcome focus is crucial to ensuring action orientation and clarity on the goal is crucial.
  • Clear, uncomplicated mechanisms for transacting – The line from A to B to introduce the least possible blocks, alongside this, information also needs to be intelligent. It should focus on the ‘point of learning’ or the ‘point of risk’ and these should be understood from the very top to the base.
  • The capacity and resource to implement change – Vision, plans and insight are all meaningless without the capacity and resource to implement the change, whether this be sufficiently trained staff, dedicated resource or the right equipment to support new processes.
  • Leadership and culture which is open, curious and committed – Leaders should ensure that there is a culture which lives good governance as part of its DNA. This means that there is an open and compassionate environment for staff but most of all, that they are proud to work for an organisation which empowers them to be curious and to learn.
  • The openness and ability to challenge, check and scrutinise – Developing a non-defensive culture which accepts scrutiny and always aims to learn and improve is crucial for good governance.

Where we regularly provide  governance support to clients:

  • NHSI Well-led governance reviews and self- assessment support – reduced cost, more concise and more value adding Well- led reviews.
  • CQC Well-led support – preparing you for inspection or supporting you with adverse inspection findings.
  • Executive Team and Board development support – we provide outstanding support to optimise executive team and Board performance.
  • Clinical and quality governance due diligence for mergers and transactions – we have extensive experience in safely surfacing unknown risks.
  • Pathway and project based governance support – we help your initiatives to gain traction through improved transactions.
  • Strategic support – make sure that governance is future fit and that your strategic direction for quality is going to deliver results.
  • Partnership governance – accountability frameworks between providers.

Better support for organisations

We use a range of tools and techniques to support our clients with their challenges or to support them to optimise their governance. We understand the importance of ensuring that our work is undertaken without undue stress on services or existing resources and we are experienced in knowing where to look and how to understand challenges quickly. Importantly, our work is collaborative and our aim is to help teams to develop rather than critique individuals. We follow the principles set out below through all of our work:


Kate Jury is Partner in Governance and Assurance at Niche.
Contact Kate.Jury@nicheconsult.co.uk

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