title: Empowerment or rhetoric? Investigating the role of NHS Foundation Trust governors in the governance of patient safety.
abstract: OBJECTIVE
  Involving patients and the public in patient safety is seen as central to health reform internationally. In England, NHS Foundation Trusts are seen as one way to achieve inclusive governance by involving local communities. We analysed these arrangements by studying lay governor involvement in the formal governance structures to improve patient safety.
  
  
  METHODS
  Interviews with key informants, observations of meetings and documentary analysis were conducted at a case study site. A national survey was conducted with all acute Foundation Trusts (n=90), with a response rate of 40% (n=36). Follow up telephone interviews were conducted with seven of these.
  
  
  RESULTS
  The case-study revealed a complex governance context for patient safety involving board, safety and various sub-committees. Governors were mainly not involved in these formal mechanisms, with participation being seen to pose a conflict of interest with the governors' role. Findings from the survey showed some involvement of governors in the governance of patient safety.
  
  
  CONCLUSIONS
  This study revealed a lack of inclusivity by Foundation Trusts of lay governors in patient safety governance. It suggests action is needed to empower governors to undertake their statutory duties more effectively and particularly through clarification of their role and the provision of targeted training and support to facilitate their involvement in the governance of patient safety.
authors.affiliation: The King's Fund, Policy Department, 11-13 Cavendish Square, London, W1G 0AN, UK. j.ocloo@kingsfund.org.uk
authors.forename: Josephine
authors.initials: J
authors.lastname: Ocloo
authors.forename: Ali
authors.initials: A
authors.lastname: O'Shea
authors.forename: Naomi
authors.initials: N
authors.lastname: Fulop
mesh_terms: D003657:Decision Making; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D061214:Patient Safety; D024382:Professional Role; D036301:Qualitative Research; D013222:State Medicine; D011795:Surveys and Questionnaires; D014341:Trustees
keywords: Decision making; Governance; Patient safety; User involvement