Brighton and Sussex University Hospitals NHS Trust - supporting the implementation of a new quality governance structure

Brighton and Sussex University Hospitals NHS Trust had been rated as ‘requires improvement’ by the Care Quality Commission (CQC) and placed in the special measures improvement regime.

A significant management priority was to strengthen the organization’s governance systems. GGI was appointed to undertake a review that considered the quality governance aspects of the trust’s overall governance arrangements and to work with the trust to implement the review’s recommendations.

The programme adopted a hands-on, development-by-doing approach. It was designed around the following interconnected streams:

• Supporting the transition to a new quality and clinical governance framework and instilling appropriate mechanisms for assurance reporting – ward to board. This was underpinned by monthly workshops, which provided a forum to jointly reflect on progress and learning points.
• Providing hands-on support to the trust’s newly formed five clinical divisions to establish monthly cycles of governance meetings and improve assurance reporting.
• Supporting the establishment and embedding of a monthly cycle of trust-wide quality assurance groups, with these groups acting as the internal regulators for quality across the organisation.
• Measurement of progress on an ongoing basis against two GGI maturity matrices – developmental tools to support the improvement of quality and clinical governance.
• Promoting the structural reforms to staff across the organisation.

• A bespoke quality governance manual for staff, to instil trust-wide understanding of the new quality governance structure.
• A stronger emphasis on empowering newly formed clinical divisions around clinical governance.
• A clear and more structured approach to discussion, reporting, and escalation at quality and governance meetings, and effective assurance processes that deliver authentic ward-to-board insight.
• Greater structure and focus to the sharing of information and points of learning, with the trust’s five clinical divisions demonstrating sustained progress with regards to enhancing their quality and clinical governance mechanisms to the benefit of patients.
• A fit for purpose central quality management capacity and capability.

The implementation of the quality governance reforms directly supported the trust to exit the special measures improvement regime in January 2019. The trust now has a combined rating of ‘good’.