|
1. Do we still have a trust board?
NHS Foundation Trusts have a board of governors and a board of directors.
Some of the board of governors are elected by the membership of the NHS Foundation Trust and are responsible for the strategic direction of the organisation. They agree this direction with the board of directors.
The board of directors is responsible for the day-to-day management of the hospital, including very important issues such as compliance with guidance and the assurance of good governance and public accountability.
Back to top
2. How is the board of governors set up?
NHS Foundation Trusts are democratic. Local people have the chance to become members, and these members elect their representatives to serve on the board of governors. There are also staff representatives as well as appointed governors representing local stakeholders and primary care trusts.
The numbers of people on a board of governors differs according to the Trust but every board of governors must have:
More public and patient governors than all the other governors put together;
At least one governor representing primary care trusts;
At least three governors representing staff;
At least one university governor for hospitals that train doctors and nurses;
A chair (who will also be chair of the board of directors).
The board of governors has the power to appoint the chair and non-executive directors. They are consulted on decisions and influence regarding the future running of the NHS Foundation Trust. They also consider the annual reports and accounts and receive other information about the NHS Foundation Trust, and be able to appoint an auditor to inspect the Trust's financial accounts.
Back to top
3. How does the board of governors fit in to the structure of the trust?
You can think of the board of governors as the equivalent of the Department of Health, which influences and signs-off strategies, and hires and fires the chairman and non-executive directors. The board of governors will:
Be an essential link between the hospital and various partner organisations;
Ensure the board of directors' operations conform to statutory guidelines and corporate and clinical governance requirements [eg The Healthcare Commission and National Institute for Clinical Excellence (NICE) guidelines];
Make sure that the work of the hospital conforms with local needs;
Hold to account the board of directors ensuring they act responsibly;
We are providing training for new members of the board of governors and board of directors with regard to their respective roles in the running of the hospital.
Back to top
4. How much did it cost to set up the board of governors?
Members of the board of governors are not paid to undertake their role. They will be eligible to receive expenses incurred while carrying out their role, such as travel expenses or childcare costs.
Back to top
5. How long will the board of governors be in post?
Governors will serve a term of one, two or three years depending on the number of votes they receive. To ensure continuity, we will phase appointments to the board of governors so that not all the governors end their term of office at the same time.
Back to top
6. Who is the board of governors accountable to?
The board of governors is accountable to the local community and the NHS Foundation Trust members.
Monitor (formely the independent regulator ) oversees the functioning of the organisation and he or she is ultimately accountable to parliament. Monitor issues a ‘licence’ or terms of authorisation under which the trust will operate. This licence specifies the protected services that trusts will have to provide. We will, therefore, be accountable to the public and membership for services provided within the terms of our licence.
Back to top
7. Are elected governors delegates or representatives?
Elected governors are representatives. If you are elected on behalf of a constituency, those electing you have done so because they believe you can take the right decisions based on the individual's judgement of the discussions at the board of governors. A single individual will not be able to represent the entire spectrum of views of their constituency.
Back to top
8. Can I be a governor of more than one NHS Foundation Trust?
Yes, but it depends on the constitution of the particular NHS Foundation Trusts. You also need to think whether you have the time and energy, and whether there might be a potential conflict of interest in holding this position in more than one organisation.
Back to top
9. Will non-elected governors only represent the interest of their organisation?
No. Appointed (non-elected) governors need to act as "guardians of the NHS foundation trust". For this to be true, if a stranger walked into a board of governors meeting, it should be difficult to decide which of the governors had been elected, which ones are appointed and which constituency they represent. This is because they will be making judgements based on their knowledge, expertise and background in the best interests of the NHS foundation trust. Which organisation they were appointed by, or constituency that elected them, is important for their role communicating decisions, discussions and the workings of the board of governors. This role is alsosupported by the Foundation Trust Office and Communications at Addenbrooke's.
Back to top
10. How many people stood as governors?
There are four types of governor:
Eight 'patient governors' elected by 'patient members' (including carers);
Seven 'public governors' elected by 'public members';
Four 'staff governors' elected by 'staff members';
Ten advisers (formerly called co-opted governors) or appointed governors by partner organisations such as local authorities, the University of Cambridge and local primary care trusts.
Back to top
11. Can patient governors only be elected by patient members?
The type of membership that is called 'patient' includes both patients and carers ie both patients and carers can join this group of members and both patients and carers can stand as governors - the name of the group and type of governor is, however, just 'patient'.
Back to top
12. Are governors being given information about what they will have to do?
People who were interested in standing for election were invited to attend a seminar that explained the role and responsibility of governorship. The three main roles for governors are:
To advise the board of directors on decisions about the strategic direction of the organisation;
To inform the development of the future strategy for the organisation;
To act as a guardian of the NHS Foundation Trust for the local community (this includes appointed governors).
Governors are also required to act in accordance with the Seven Principles of Public Life from the Nolan Committee
From the Standards in Public Life website: The Nolan Committee has set out 'Seven Principles of Public Life', which it believes should apply to all in the public service.
The role of the governors is very important to ensure a link between the members of the NHS Foundation Trust, the wider community and those who run the hospital.
Back to top
13. Are the governors being given training?
Governors will need to develop skills to enable them to work effectively as a group. They all undergo various types of specific training and development, depending on their current skills and past experience.
When they were newly elected, there was an induction day to provide them with further information about the hospital and the work of the board of governors.
Individual governors then took part in a ‘training needs analysis’, which helped identify areas for which they would like to receive further training.
There is also be a programme of development for all 33 members of the board together, to ensure that they can work well together as a group.
Back to top
14. What will be the first roles/tasks of the governors?
The first task of the governors was to appoint the chair and the non-executive directors of the new organisation. They also had to approve and agree to a number of proposals to allow the new organisation to function. For example to discuss with the board of directors the appointment of an auditor to the trust.
When the board is fully established, they will then discuss a wide range of issues including the strategy for clinical services and the development of the hospital site.
Back to top
15. How are the elected governors different from the members of the trust board?
Elected governors have the role of advising on the strategic direction of the organisation, based on their knowledge and experience. They are, in effect, guardians of the organisation for the three constituencies: staff, local community ('public') and patients/carers.
Non-executive directors on the board of directors also bring lay expertise to the running of the hospital. They are different, however, because they take an active role in the day-to-day running of the hospital, chairing committees and taking specific responsibilities relating to different areas. These include financial management, ethics and information technology.
A governor might have an interest in one of these areas but they would not have responsibility for it in the new structure. Non-executive directors will continue to serve the trust, and will chair and take part in their existing committee and other work
Back to top
16. How will the roles of staff governors compare with those of patient and public members?
The role of a governor is the same whichever constituency the governor represents. They all have the responsibility to act as guardians for the organisation and ensure that the right strategic decisions are made for the future of the hospital.
All governors have to provide information to their constituencies. Because these constituencies are very different, the ways in which information is communicated might differ from governor to governor and from constituency to constituency.
Back to top
17. Why are some governors elected and others nominated from other organisations?
Governors from partner organisations are appointed, and governors from the staff, public and patient constituencies are elected. The legislation created this governance structure in order to ensure a strong element of democratic responsibility to local people for the running of the hospital. The best way to assure this accountability was by identifying a proportion of the governing body that had to be elected.
However, members of parliament were keen to ensure continued partnership working with organisations that were already involved in health and social care, education and research. They, therefore, provided for appointed governors, who are appointed on behalf of the organisations for which they work. This would allow the individuals to change as people move from job to job, but ensures that the organisation itself would always be represented.
|
