The document outlines the development of integrated governance within the NHS, emphasizing the need for clarity in objectives and responsibilities. It details a framework for effective operational delivery, risk management, and assurance processes to minimize hazards and improve patient engagement. The next steps include implementing a new structure for effective reporting and fulfilling health standards by October.

1. Integrated governance Daniel McNally NHS Patient Engagement and Development

2. Summary So Far Develop shared understanding Clarity of objectives and responsibilities (what we needed) Review existing framework Go live!

3. Integrated governance conceptual model Delivery Responsibility for operational delivery of principal activities Assurance Judgment based on robust evidence that hazards are being minimised through effective controls. May necessitate independent assurance for key control systems. Direction Clear strategy and priorities for the organisation and services. Integrated Governance Overall system to determine and manage delivery of objectives and provide assurance on the effectiveness of controls. Risk management Processes involved in identifying, assessing and judging risk and taking action to mitigate or anticipate hazards

4. The vision Ensure governance not in silos and is comprehensive WHILST avoiding duplication Support existing and new activities e.g. Board Assurance Framework (existing) Standards for Better Heath (new) Separate assurance and operational responsibilities (Board and Executive)

5. Existing Framework Directorate implementation (4 steering groups) Activity based: incidents, safety alerts, NSFs and controls assurance (clinical) Risk management systems (incidents, risk assessment, complaints & claims) Raising funding issues outside the executive management structure. Inevitable Board drawn into operational delivery

6. Next steps Implementation of new structure (started June) Ensure effective reporting: Escalation (appropriate level of hazard and timely) Assurance (level of detail and action) Deliver evidence for Board’s Standards for Better Health declaration (October)