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Monitor consults on new quality governance framework

Monitor, the independent regulator of NHS Foundation Trusts, is launching a consultation which proposes enhancing the assessment of quality governance in Trusts applying for foundation status, and sets out a ‘quality governance framework’ for Boards. These new proposals, published recently, provide Boards of applicant Trusts with an essential toolkit to assess how well their organisations manage and understand quality. 

Quality governance refers to the Board’s leadership on quality and their ability to understand the relative quality of services their Trust provides; identify and manage risks to quality; act against poor performance; and implement plans to drive continuous improvement.

In an environment of tighter public finances and the need to make significant efficiency savings, it is crucial that all Boards of NHS organisations are able to identify and manage risks to the quality of their services in the same way they would their financial position. 

The NHS as a whole will face a significant challenge in maintaining and improving quality in this environment. The proposed new quality framework will help Boards meet this challenge by enabling Boards to self-assess their approach on managing quality. Monitor will then test and challenge this evaluation during the assessment process.

The framework is set out as a series of ten key questions which test applicants’ approach to quality in four areas and provides examples of good practice for each area. The four areas are:

  • Strategy;
  • Capabilities and Culture;
  • Processes and Structure; and
  • Measurement

The proposals do not fundamentally alter the existing requirement for all applicant foundation trusts to demonstrate to Monitor that they are well governed.  However, they do represent an enhancement of Monitor’s current assessment of quality governance in applicant NHS foundation trusts, and build on the rigour of the existing process.

Commenting on the proposed changes, Chris Mellor, Acting Chair of Monitor, said:

“All NHS Boards will have tough choices to make as the funding slowdown begins to bite, but this cannot mean any compromise in essential quality standards. There is a risk that Boards will come under pressure to trade off quality for financial performance. They need to be aware of this, to understand how this trade-off manifests itself, to look for the indicators that tell them this is happening and to take appropriate action.

“That’s why Monitor is consulting on a new framework that highlights the key questions Boards should be asking themselves on how their organisation manages and understands quality in order to assure themselves – and us – that they are up to the challenge ahead.

Monitor is building on our existing assessment of governance to provide extra assurance that applicant Boards can deliver on the responsibility that NHS foundation trusts have to deliver high quality services for patients.”

If this enhanced approach to quality governance is adopted following this consultation exercise, it will apply to applicant foundation trusts referred to Monitor after 1 June 2010.

Notes

  1. The consultation on an update to the Guide for Applicants is available on Monitor’s website:  http://www.monitor-nhsft.gov.uk/home/our-publications/browse-category/consultations/monitors-consultations/consultation-update-the-g
  2. Deadline for responses is  Tuesday 6 April 2010.
  3. Monitor authorises and regulates NHS foundation trusts, ensuring they are well-managed and financially viable in order to deliver high quality healthcare for patients.
  4. Monitor was established in January 2004. It is independent of government and accountable to Parliament. Monitor’s functions and powers are set out in the National Health Service Act 2006.

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