Meta regulation meets deliberation : situating the governor within NHS foundation trust hospitals
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NHS Foundation Trust (FT) Hospitals in England have complex internal governance arrangements. They may be considered to exhibit meta-regulatory characteristics to the extent that Governors are able to promote deliberative values and steer internal governance processes towards wider regulatory goals. Yet, while recent studies of NHS FT Hospital governance have explored the role and experience of FT Governors and examined FT hospital Boards to consider executive oversight, there is currently no detailed investigation of interactions between Governors and members of hospital Boards. Drawing on observational and interview data from four case-study sites, we trace interactions between the actors involved; explore their understandings of events; and consider the extent to which the benefits of meta-regulation were realised in practice. Findings show that while Governors provided both a conscience and contribution to internal and external governance arrangements, the meta regulatory role was largely symbolic and limited to compliance and legitimation of executive actions. Thus while the meta-regulatory ‘architecture’ for Governor involvement may be considered effective, the soft intelligence gleaned and operationalised may be obscured by ‘hard’ performance metrics which dominate processes and priority setting. Governors were involved in practices that symbolised deliberative involvement but resulted in further opportunities for legitimising executive decisions.
Millar , R , Freeman , T , Mannion , R & Davies , H T O 2019 , ' Meta regulation meets deliberation : situating the governor within NHS foundation trust hospitals ' Journal of Social Policy , vol. 48 , no. 3 , pp. 595-613 . https://doi.org/10.1017/S0047279418000739
Journal of Social Policy
© 2018, Cambridge University Press. This work has been made available online in accordance with the publisher’s policies. This is the author created accepted version manuscript following peer review and as such may differ slightly from the final published version. The final published version of this work is available at https://www.cambridge.org/core/journals/journal-of-social-policy
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