Governance Award

Endorsed and sponsored by ACCA

This award is made to an individual, team or organisation that has introduced a change (big or small) to its assurance, risk management or governance arrangements in order that the organisation as a whole is better able to achieve its objectives.  The aim of the award is to promote a strong, integrated approach to governance.

 

Winner University Hospital of South Manchester NHS Foundation Trust

Also shortlisted DAS/NHS Dorset;  Norfolk and Waveney Mental Health NHS Foundation Trust; North Essex Partnership NHS Foundation Trust

The Mancunian way
University Hospital of South Manchester NHS Foundation Trust overhauled its approach to risk after it was placed in significant breach of its terms of authorisation in July 2009. Not only has its new model ensured the trust now has a green governance rating (removed from the list of trusts in significant breach in June 2010), but it has been taken up by other organisations and has won the trust the 2011 HFMA Governance Award.

The model, known as the South Manchester Way, was developed with staff and seeks to clarify why risk management is important, to enhance the visibility of risk and its effects, and to help draw attention to detail to control risk.

The judges highlighted the involvement of staff in the process. ‘The new model was rolled out and over an 18-month period was fully embedded in the organisation with full engagement by all staff,’ they said.

‘The result has been a simple but effective risk management process that is fully understood and used across the trust, with clear presentation to the audit committee resulting in dramatically improved governance,’ they added.

‘Significant assurance was given by both the external and internal auditors and the innovative approach has been taken up by a number of other trusts.’

The objectives the trust wishes to achieve are just the start of the process. Typically, these include developmental and maintenance goals – the latter addresses what must be achieved to keep the trust operational, such as maintaining Care Quality Commission registration and delivering a surplus.

Previously, the trust’s risk register was a list of concerns and potential adverse outcomes. But these tended to make risks less visible and produced a plethora of information that added little value.

Under the new model, risk is linked directly to the trust’s objectives, and any concerns that have no impact on its objectives are not considered risks. To mitigate risks, the trust reviewed its controls at ward and departmental level and produced risk profiles for each following a series of workshops with clinicians. Controls that were being relied upon but had been previously invisible to the board were now clear. Risk registers were overhauled to reflect these control measures.

The risk process is challenged through a chief risk officer and, as it is integrated with the trust’s performance management framework, checks are made through, for example, routine reporting and spot checks.

‘This is a terrific tribute to all the staff at the trust,’ said Paul Moore, the trust’s chief risk officer. ‘Their efforts in helping to identify and control risk have led to this award. It has helped us make substantial improvements to both the quality and reliability of care.’

Chief executive Julian Hartley paid tribute to Mr Moore’s contribution in raising the management and understanding of risk at the trust. ‘Greater clarity has underpinned the whole process and has helped raise the importance of risk management at every level across the organisation,’ he said.

 

The Judges

John Yarnold, Chair, HFMA Governance & Audit Committee

Barbara Byrne, Director of Finance, West London Mental Health NHS Trust

John Bullivant, Director, Good Governance Institute

Ian Turner, Director of Finance, HFMA

Julia Rudrum, ACCA