Good governance outcomes for CCGs:

A maturity matrix to support development

and improvement of CCGs

Good Governance Institute

Part of a programme commissioned by

NHS England

Publications gateway reference number 03852

GoodGovernanceInstitute

1 Introduction

The Good Governance Institute has been commissioned by NHS England to develop a

language for governance that is appealing to Clinical Commissioning Groups (CCGs),

and a proposed set of outcomes of good governance that can be described and

measured.

As part of this work, we have developed a suite of tools that CCGs can use with minimal

external input, to test whether they are achieving good governance outcomes. These

tools have been developed with the input and participation of CCGs, and are:

• amaturitymatrixtoguideself-assessmentagainstthegoodgovernance outcomes

• asurveytotesttheviewsofinternalandpotentiallyexternalstakeholdersasto whether the good governance outcomes have been achieved

• apeerreviewguidetoenableCCGstolearnfrompeers• anobservationguidetosupportthereviewofCCGmeetingssuchasthe governing body

• astandardsandevidencetooltoenableCCGstoevidencehowtheyare achieving good governance outcomes

The tools have been developed to identify the outcomes of good governance and so the

outcomes of the governance of new processes such as collaborative commissioning and

co-commissioningreadacrossthisworktoo.

The website for this work www.ccggovernance.org includes further details of how

these tools were developed, as well as downloads of the tools themselves.

1

2 A guide to using the maturity matrix to support development and

improvement of governance

ThismaturitymatrixisdesignedtohelpCCGsself-assessthattheyareachievingtheexpected desirable outcomes of good governance practice.

The maturity matrix describes the key elements of good governance outcomes along the

y-axis,andgraduationsof‘maturity’alongthex-axis.Foreachofthekeyelements,wehaveidentifiedindicativestatementssothataCCGcanself-assessitslevelofmaturity.The matrix can be used to agree developmental expectations, as well as current status.

Forexample,aCCGmayidentifythatitiscurrentlyat‘earlyprogress’stageinregardto‘clarityofpurpose’,andaspirestoreach‘results’withintheyear.

A CCG will not usually be at the same stage for all elements of good governance

outcomes.Forexample,itcouldbeagreedthatfor‘leadershipandstrategicdirection’ithasreachedlevel3,butfor‘membershipsupport’justlevel1.Ifforanyelementitisfeltthat the CCG has not even reached level 1(basic level), then this can be indicated as a

‘no’.

The maturity matrix can be used in a variety of ways:

• Itcanbeusedasasimpleself-assessmenttool.• Atagoverningbodydevelopmentsession,membersofthegoverningbody could‘vote’wheretheyfelttheCCGwasonthematrixandthen,througha facilitated discussion, agree a group decision about current scorings and

developmental aspiration.

• Itcouldbeusedtotesthowdifferentstakeholdersunderstandthegovernance arrangements, and to identify any communication or other developmental issues.

• ThematrixcouldalsobecomparedbyseveralCCGsasabenchmarkingtoolto identify examples of good practice that other CCGs could learn from.

• Thematrixcanalsobeusedaspartofsomeoftheothertoolsdevelopedinthis series: to help frame thinking and feedback for the observation tool, for example.

2

3