Quality governance framework


Quality Governance is defined as:
the combination of structures and processes at and below board level to lead on organisation‐wide quality performance including:

  • ensuring required standards are achieved
  • investigating and taking action on sub‐standard performance
  • planning and driving continuous improvement
  • identifying, sharing and ensuring delivery of best‐practice
  • identifying and managing risks to quality of care’[1]

In our Quality Strategy 2013-2016, the Quality Executive Committee undertook to use the Quality Governance Framework developed by Monitor, the regulator for NHS Foundation Trusts and NHS Trusts in England[2], to test the robustness of Waitemata DHB’s quality governance framework. As part of this work, the Committee addressed two questions that form part of the Quality Governance Framework guide:

  1. Processes and Structure - Are there clear roles and accountabilities in relation to quality governance? [Question 3A of the Quality Governance in the NHS - A guide for provider boards]
  2. Processes and Structure - Are there clearly defined, well understood processes for escalating and resolving issues and managing quality performance? [Question 3B, Quality Governance in the NHS - A guide for provider boards]

Quality Governance Framework

We reviewed the structures and processes we had in place in relation to quality governance, which included a gap analysis to identify ‘gaps’ and lack of clarity in roles and accountability. We mapped structures and reporting lines to describe how responsibility for delivering quality performance is cascaded from ‘board to ward to board’ and how quality performance issues are escalated to the board. The result of this work is an updated and more detailed quality governance framework .

Waitemata DHB Quality Governance Framework
[View our Quality Governance Framework]


  1. "Quality Governance in the NHS - A guide for provider boards". National Quality Board. March 2011
  2. "Quality Governance Framework", Monitor, July 2010

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