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Individual legal duties create ‘governance challenges’ to system working

A financial expert has today stated that one of the biggest challenges facing the NHS in England is in moving to system-wide working – and strong governance is vital for trusts to move that forward effectively.

In a blog written by the Healthcare Financial Managers Association’s (HFMA’s) technical editor, Sarah Bence, trusts were told to move away from an organisational focus to looking at how to deliver services that are cost-effective across whole systems instead.

The financial expert explained that governance is concerned with how organisations are run, structured and held to account for their actions or decisions. Bence goes on to argue that governance is not leadership, and should run throughout trusts at every level.

“Good governance is not something that can be taken for granted,” she wrote. “It takes planning, foresight and co-operation. NHS bodies must set up strong processes and regularly check these processes are fit for purpose.

“Perhaps the biggest challenge facing the NHS in England now is to move to system working – partnership working at scale and quite often implemented quickly,” she continued. “Moving away from an organisational focus to looking at how to deliver quality services that are cost-effective across whole systems makes sense.

“But doing it while we retain the existing system architecture and the requirement for individual organisations to meet their statutory duties provides some real governance challenges.”

The HFMA lead also stated that governance is set to be “fundamental” to the transformation agenda at NHS organisations.

“There can be a tendency to equate governance to bureaucracy – which tends to be used these days in a pejorative way,” she concluded. “In fact, it is anything but an add-on process, with good governance an integral part of delivering high-quality healthcare.”

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