Governance Structure
GREENBoard-level governance structures are established with clear roles, responsibilities, and reporting lines.
- Board assurance reports
- Committee terms of reference
- Role descriptions and accountability
Board Assurance
Green/Amber framework for board reporting with detailed rationale, mitigation plans, and improvement tracking for Quality & Safety Committee and Full Board.
How assurance is assessed and reported using Green/Amber ratings (no Red ratings to maintain board confidence).
Arrangements are working effectively, with regular monitoring and improvement. No significant concerns identified.
Arrangements are in place but require improvement. Specific concerns identified with mitigation plans in progress.
Detailed assurance ratings with operational depth for committee-level oversight.
Board-level governance structures are established with clear roles, responsibilities, and reporting lines.
Risk identification, assessment, and mitigation processes are operating effectively with regular monitoring.
PSIRF framework is implemented but requires maturity improvement in proportionate response selection and learning documentation.
Incident learning is identified but consistency of sharing and improvement tracking requires enhancement.
Strategic assurance summary for board-level oversight and external reporting.
Organisation has effective governance structures with specific areas requiring improvement for full assurance.
How RAG ratings are monitored, reported, and used for improvement.
RAG ratings are reviewed monthly with evidence assessment and progress tracking against mitigation plans.
Formal RAG dashboard reports to Quality & Safety Committee and Full Board with detailed rationale.
Comprehensive annual assessment of assurance framework effectiveness and improvement planning.
Ratings validated against external assessments including CQC inspections and peer reviews.
Implement structured RAG reporting with detailed rationale and mitigation planning for effective board oversight.