Governance challenges in healthcare include building trust through demonstrating better governance, making patient safety the top priority, and adapting to new models of healthcare financing and information flows. Leadership must attract the right talent to boards, put patients first, and embed ethical behaviors. Patient safety must be the foremost concern at all governance levels through driving compelling safety plans, empowering clinicians, and monitoring standards. New financing models require understanding costs by procedure, operating effectively in commissioning, and developing financial skills in areas like coding and billing. Integrated, KPI-driven information flows with clear responsibilities and a focus on safety and risk data will also be critical as data analytics become core to finance.