Meta-regulation meets Deliberation: Situating the Governor within NHS Foundation Trust Hospitals

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Meta-regulation meets Deliberation: Situating the Governor within NHS Foundation Trust Hospitals. / Millar, Ross; Freeman, Tim; Mannion, Russell; Davies, Huw.

In: Journal of Social Policy, 05.11.2018.

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@article{e37c20d5c2014e14bef1c07449b077bf,
title = "Meta-regulation meets Deliberation: Situating the Governor within NHS Foundation Trust Hospitals",
abstract = "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 FT governors and examined FT hospital boards to consider executive oversight, there is currently no detailed investigation of interactions between these two groups. 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 proposed 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 resource-allocation processes and priority-setting. Governors were involved in practices that symbolised deliberative involvement but resulted in further opportunities for legitimising executive decisions.",
author = "Ross Millar and Tim Freeman and Russell Mannion and Huw Davies",
year = "2018",
month = "11",
day = "5",
doi = "10.1017/S0047279418000739",
language = "English",
journal = "Journal of Social Policy",
issn = "0047-2794",
publisher = "Cambridge University Press",

}

RIS

TY - JOUR

T1 - Meta-regulation meets Deliberation: Situating the Governor within NHS Foundation Trust Hospitals

AU - Millar, Ross

AU - Freeman, Tim

AU - Mannion, Russell

AU - Davies, Huw

PY - 2018/11/5

Y1 - 2018/11/5

N2 - 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 FT governors and examined FT hospital boards to consider executive oversight, there is currently no detailed investigation of interactions between these two groups. 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 proposed 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 resource-allocation processes and priority-setting. Governors were involved in practices that symbolised deliberative involvement but resulted in further opportunities for legitimising executive decisions.

AB - 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 FT governors and examined FT hospital boards to consider executive oversight, there is currently no detailed investigation of interactions between these two groups. 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 proposed 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 resource-allocation processes and priority-setting. Governors were involved in practices that symbolised deliberative involvement but resulted in further opportunities for legitimising executive decisions.

U2 - 10.1017/S0047279418000739

DO - 10.1017/S0047279418000739

M3 - Article

JO - Journal of Social Policy

JF - Journal of Social Policy

SN - 0047-2794

ER -