Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what performance and regulatory framework NHS England operates to ensure that clinical commissioning groups meet standards of good governance; and what powers NHS England has to take action where there are instances of governance failures falling below the standard set in those frameworks.

NHS England currently assesses clinical commissioning groups’ (CCGs) governance arrangements through two indicators in the leadership domain of the 2016/17 CCG Improvement and Assessment Framework.

This features a quality of leadership indicator, which reviews the CCG’s governance framework to ensure that responsibilities are clear, regular review is built in, and that quality, performance, and finance risks are understood and managed. Characteristics of strong financial leadership are particularly highlighted.

A probity and corporate governance indicator focuses on conflicts of interest and assesses compliance with a number of requirements of the managing conflicts of interest revised statutory guidance for CCGs, published on 28 June 2016, based on sections 14O and 14Z8 of the NHS Act 2006 (as amended). A requirement of the strengthened guidance is for CCGs to include an annual audit of conflicts of interest within their internal audit plan and to include the findings of this audit within their annual end of year governance statement.

NHS England is supported by legislation in exercising formal powers of direction, as laid out in section 14Z21 of the NHS Act 2006 (as amended), if it is satisfied that a CCG is failing or is at risk of failing to discharge its functions. This may be applicable in cases of serious or systemic governance failure.