Clinical Commissioning Groups (CCGs) were established in 2013 to give General Practitioners and other clinicians authority to make commissioning decisions on behalf of patients. Today, with the difficult financial position across the NHS and delegation of commissioning services to CCGs, they face increased challenges – and a rise of potential risks and threats.
This has culminated in increased pressure for Governing Bodies to be assured on control mechanisms and frameworks used in managing these risks and a search to identify opportunities for improvement. It is important that the board assurance framework is central to CCGs’ governance and reporting processes, to enable understanding of assurances available and assess cost and resource used in mitigating identified risks.
The Department of Health produced an Integrated Governance Handbook to provide guidance and support for organisations to review their governance and assurance.
The handbook provides two primary reasons why a strong board assurance framework is crucial to a Governing Body:
- to be in control of their agenda; and
- to be confident their systems, policies and people are effective in driving delivery of objectives by focusing on identifying, prioritising and minimising risk.
RSM provides internal audit services for 36 CCGs clients, primarily in London and the South East. This has given us unique insight into risks CCGs face and common themes and best practice in their board assurance frameworks.
To share this insight and provide an industry benchmark, we compared the board assurance frameworks of our 36 CCGs clients, identifying themes, trends and examples of good practice. We also identified six key areas for improvement the industry can focus on to achieve a strong board assurance framework.
This report details our findings based on our work completed throughout 2017/18.