ABSTRACT

This chapter focuses on the decentred governance literature as a framework to examine the enactments of Board governance of patient safety at several Foundation Trust hospitals within the English National Health Service (NHS). It describes conceptual framings of corporate governance that may inform local practices, and outlines the regulatory context of patient safety governance within the English NHS. The chapter explores the situated agency of Board members in relation to the governance of patient safety within case study sites. It also focuses on the findings from a larger National Institute for Health Research funded study of the governance of patient safety. A range of competing conceptual framings have been used to understand the governance role of Boards, and which inform the situated agency of local actors. Local hospital Trust Boards were first introduced in the English NHS in 1990. Public service reforms in England typically emphasise performance and accountability, rather than renewal and entrepreneurship.