Governance Arrangements for Health and Social Care

Background

Good governance involves clarity, openness and taking account the views of the public including service users.

Good governance is of particular importance for Jersey’s health and social care because of:

• the scale of States expenditure in this area
• the substantial changes being implemented within health and social care
• the incidence of high-profile failings in health and social care where governance arrangements were unsatisfactory; and
• the need for public confidence in the health and social care system.

Scope

This review evaluates the effectiveness of arrangements for the governance of health and social care, reflecting governance structures in place up to May 2018 and how the proposals for changes had been developed.

The review does not extend to the operation of or expenditure from the Long-Term Care Fund.

Conclusions

The governance arrangements for Health and Social Care were inadequate: 

• at an overall system level, the arrangements were overly complex for a relatively small health and social care system and at the same time poorly defined and communicated; and 
• in many respects the Integrated Governance Committee, that had key responsibilities for securing clinical governance, was not fit for purpose. 

Proposals for structural change were developed without a clear, documented evaluation of current arrangements and without a clear trail from the analysis undertaken by the consultants to the proposal developed.