ACCA and Department of Health NHS governance survey document now available online

On 27 March 2008 Healthcare Governance Review reported summary results of Understanding governance in the NHS – a research project by ACCA’s Health Service Network in collaboration with the Department of Health (click here for 27 March post).

The aim of the research was “to identify current understanding of governance in the NHS.” The report states that “It is…..interesting that this understanding is firmly based on the Cadbury Committee’s definition of corporate governance, rather than on any subsequent definition designed purely for the NHS.”

Unfortunately for ACCA and the Department of Health, their own understanding of the Cadbury Committee definition of corporate governance is seriously flawed. They state that the Cadbury definition is” “The system by which an organisation is directed and controlled, at its most senior levels, in order to achieve its objectives and meet the necessary standards of accountability and probity.” The actual Cadbury definition is “….the system by which companies are directed and controlled.”

Interestingly, Healthcare Governance Review received the following written feedback from the launch of the ACCA/DH Understanding governance in the NHS from an NHS non-executive director with substantial governance knowledge and experience. She said that “The lack of understanding of governance on the platform and in the audience was amazing – governance still means management to most of the people who spoke – and the lack of understanding about governance structures and systems in the NHS in particular FTs was surprising.” She also expressed concern at what she felt was a “very small” response rate to the questionnaire, and the fact that the report’s author, when questioned, apparently could not say whether any individual organisations had provided multiple responses – i.e. more than one board member from an organisation had responded to the questionnaire. From an academic research perspective, the report appears methodologically unsound, making its findings and conclusions suspect.

Healthcare Governance Review believes that all of the above adds to the body of evidence underpinning Professor Paul Stanton’s assertion of “confusion and muddle in the DH and NHS about the nature of governance” (click here). Sadly, it is difficult to take seriously a research report that is based on the wrong understanding of the Cadbury Committee report’s definition of corporate governance – a definition which is subsequently used elsewhere in the report to base findings on.

Healthcare Governance Review further believes that the ACCA/DH report should contain a ‘Government health warning’. Treat the report, and particularly its findings and conclusions with caution!

Download the full research report here.

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