10.03.15
Improved partnership governance needed across the NHS
Only 15% of NHS leaders believe they have ‘strong’ or ‘embedded’ collaborative governance arrangements in place, a new study has revealed.
The ‘Unchartered Waters’ report found that the weakest collaborative relationships and partnership governance arrangements exist between clinical commissioning groups (CCGs)/trusts and Healthwatch, social enterprises, third sector organisations and the private sector, whilst these were stronger between trusts and CCGs.
The Grant Thornton analysis, which included responses from leaders within CCGs (53 respondents) and trusts (63 respondents), highlighted that ‘people’ features in the top three strategic risks of 12% of NHS organisations, having moved from 6% – the biggest annual leap of any risk area.
Bill Upton, head of healthcare at Grant Thornton, said: “Many NHS organisations are making good progress on governance, under very difficult circumstances. Our report highlights examples of good practice on innovation, integration and stakeholder empowerment.
“Devolution and new models of care are now truly underway and, with Greater Manchester announced as the first region to be given control of its own NHS budget, we are likely to see more regions and local health economies follow suit.”
But he added that at the same time the evidence presents a number of key governance challenges and opportunities.
Collaborative governance arrangements are expected to play a key role in developing new models of care under the NHS Five Year Forward Banner, but challenges remain with the integration agenda.
Respondents highlighted that with regards to the Better Care Fund the main governance risks associated with increased pooled funds are seen to be unclear lines of accountability (82%) and control over outcomes (71%).
In fact, 59% of trusts and 30% of CCGs were unclear about where accountability and delegation of authority lie between the health and wellbeing boards and respective partners.
Paul Hughes, public sector governance lead at Grant Thornton, added: “Effective collaboration must be underpinned by good governance if quality and financial sustainability challenges are to be met. It is still early days for the new arrangements but clearly more needs to be done to ensure NHS organisations are working together effectively to improve local health economy outcomes.”
UPDATE
A Department of Health spokesperson told NHE: “Our bureaucracy-busting reforms to the NHS are saving £1.5bn a year and have put budgets and power in the hands of local doctors and nurses — those who know best what their patients need. As part of our long-term goal to move more care into the community all partners in the NHS need to continue working together to plan and deliver local services so patients receive the best care and treatment.”
Tell us what you think – have your say below or email [email protected]