Compliance with the Code of Governance for NHS Provider Trusts

Good governance

In this section, you can read about governance through our membership and governors, and how we collaborate to provide the population of Lincolnshire with the compassionate, quality care we are committed to delivering.

The Code of Governance for NHS providers, most recently revised in April 2023, is based on the principles of the UK Corporate Governance Code issued in 2012. The Trust has not identified any areas of noncompliance in 2023/24.

The Trust has applied the principles of the NHS Foundation Trust Code of Governance on a comply or explain basis. The NHS Foundation Trust Code of Governance is based on the principles of the UK Corporate Governance Code.

The Board of Directors has established governance policies in the light of the main and supporting principles of the Code of Governance; these are detailed on the Trust website at www.lpft.nhs.uk/policies

The Board of Directors receives quarterly reports via the Audit Committee allowing it to monitor compliance with governance arrangements and, on an ongoing basis, to identify areas for further development. The Board Assurance Framework and the Trust’s governance arrangements are scrutinised by  the Audit Committee before being considered by the Board to ensure compliance with the provisions of the Code of Governance for NHS Foundation Trusts and the NHS Oversight Framework.

Governance and Constitutional Powers

The Trust’s Constitution sets out the requirements of governance and in 2022/23 it was compliant with the NHS Foundation Trust Code of Governance. The Trust’s Constitution is supported by standing orders for the Board of Directors, standing orders for the Council of Governors and codes of conduct and responsibility documents for each.

The Trust’s Constitution and standing orders set out the powers of both the Council of Governors and Board of Directors. These are further described in the standing financial instructions and scheme of delegation, all of which are publicly available on the Trust’s website at www.lpft.nhs.uk/corporate-governance.

So far as the Directors are aware, there is no relevant audit information of which the NHS Foundation Trust’s auditor is unaware, and the Directors have taken all the steps that they ought to have taken as Directors to make themselves aware of any relevant audit information and to ensure the NHS Foundation Trust’s auditor is aware of that information.

Fit and Proper Persons

All members of the Board of Directors are assessed to ensure they meet the ‘fit and proper persons test’ as described in the provider licence. With effect from 31 March 2024, checks for all Board members are being carried out in line with NHS England’s Fit and Proper Person Test Framework for board members and all required checks are carried out on appointment, and in the case of re-appointment of a non-executive director, on re-appointment. This includes, but is not limited to, references, an enhanced Disclosure and Barring Service check, checks against Companies House disqualified director and Individual Insolvency Register. As required by the Framework, all Board members will also undergo a number of annual checks.

Register of interests

Governors and directors are required to, and have signed to say that they will, comply with their respective codes of conduct and declare any potential conflict of interest. Registers of interest are maintained of the governors’ and directors’ interests. These registers can be accessed on the Trust’s website at www.lpft.nhs.uk/corporate-governance.

Compliance with the Code of Governance

The NHS Foundation Trust Code of Governance has been applied to all clauses of the Trust’s Constitution. The processes to ensure a successful and constructive relationship between the directors and governors are set out in detail in Annex 8, section 2 of the Trust’s Constitution.

The Board considers itself compliant with all provisions of the NHS Foundation Trust Code of Governance and has made the required disclosures in this annual report. Whilst the Trust is fortunate not to have had the need to address any disagreements between the Board of Directors and Council of Governors to date, it is aware of the requirement contained within the NHS Foundation Trust Code of Governance and is in the process of implementing a protocol, for approval by the Board of Directors and Council of Governors, in the case that should this be required in the future.

Challenge and assurance

The Board and, in particular non-executive directors, is able to challenge assurances received from the executive management. Information is presented in such a manner to ensure that there is sufficient understanding and information to enable challenge and to take decisions on an informed basis.

Members of the Board of Directors can access independent professional advice at the Trust’s expense, where they judge it necessary to discharge their responsibilities as directors. The Board has a duty to notify the regulator, and the Trust’s Council of Governors, and also must consider whether it is in the public’s interest to disclose any major, or potential new developments in the Trust’s sphere of activity (which are not currently public knowledge), which it is able to disclose and which may lead by virtue of their effect on its assets and liabilities, financial position or on the general course of its business, to a substantial change to the organisation’s financial wellbeing, healthcare delivery performance or reputation and standing.

NHS Oversight Framework: Disclosure

NHS England’s NHS Oversight Framework provides the framework for overseeing integrated care systems, which includes provider organisations, and identifies any potential support needs. The framework looks at six national themes:

• Quality of care
• Access and outcomes
• Preventing ill-health and reducing inequalities
• People
• Finance and use of resources
• Leadership and capability

Based on information from these themes, providers are segmented from one to four, where four reflects providers receiving the most support, and one reflects providers with maximum autonomy. A foundation trust will only be in segments three or four where it has been found to be in breach, or suspected breach, of its licence.

Throughout 2023/24 the Trust has been in segment one of the framework, which indicates that no targeted support has been required. The Trust operates within the Lincolnshire system which, in 2023/24 having successfully exited a financial recovery programme, was moved from segment four to segment three.

This segmentation information is the position as at 31 March 2024. Current segmentation information for NHS trusts and foundation trusts is published on the NHS England website.