ABSTRACT
The establishment of the management systems of an NHS Trust follows a simple, well-understood path. After the Secretary of State appoints the Chair, he/she and the other nonexecutives appoint a Chief Executive and the rest of the Trust board. One important aspect of beginning to see clinical governance and controls assurance as holistic is to understand that rogue behaviour is likely to occur across the spectrum. That is, an individual who is negligent in a clinical way also may fail to observe scrupulous standards of financial probity. It is worth remembering that A1 Capone was only ever convicted for tax evasion. To describe controls assurance in the NHS as an industry would be to belittle the efforts of the finance function. The chapter also sets out a number of parallels between financial governance and clinical governance.
