Governance Handbook

Governance Handbook

Home » Your NHS Integrated Care Board » Governance » Governance Handbook

1 July 2022

1. Introduction and overview

1.1 Introduction

The Staffordshire and Stoke-on-Trent Integrated Care Board (ICB) was established on the 1st July 2022 by the Health Care Act (2022). The Act established the statutory framework to support greater collaboration and partnership working to integrate services for patients. The ICB is part of the wider Integrated Care Partnership.

The Staffordshire and Stoke-on-Trent Integrated Care Partnership is made up of of health and care organisations, including primary care, acute providers, mental health, community care services and local authorities, that have come together to plan and deliver joined up services for our community and improve the health of people who live in Staffordshire and Stoke-on-Trent.

The purpose of the ICB is to achieve the following four aims:

  • Improve outcomes in population health and healthcare
  • Tackle inequalities in outcomes, experience and access
  • Enhance productivity and value for money
  • Help the NHS support broader social and economic development

The Staffordshire and Stoke-on-Trent Integrated Care Board has responsibility for the commissioning and oversight of services and is accountable for NHS spend and performance.  It also sets the strategic direction across the system.

1.2 Purpose of the Handbook

The Governance Handbook (“the Handbook”) for the Staffordshire & Stoke-on-Trent Integrated Care Board (ICB) brings together a range of documents which support the ICB’s Constitution and promotes good governance.

Corporate governance involves a set of relationships between an organisation’s management, board and other stakeholders.  Governance regulates the power and decision making of a small group of people who have been given responsibility for the stewardship of public assets and healthcare services. In the ICB, good governance protects both patients and public funds.

It also protects the reputation of clinicians and others involved in decision-making. Governance exists to ensure that decision-making is lawful, statutory duties and wider legal, regulatory duties are met, and that decision-making is enhanced from a quality and scrutiny perspective.

The Handbook and the ICB’s’ Constitution closely link to each other. Unless it is specifically stated, this Handbook is applicable in its entirety to the Staffordshire & Stoke-on-Trent ICB.

This Handbook sets out in detail the governance arrangements that will support the implementation of the ICB’s Constitution.  It contains practical procedural details for applying the ICB Constitution including the Terms of Reference for committees.

The Handbook is not a legal requirement. Rather it is a collection of key documents and underpinning policies, designed to promote good governance across the ICB.

If there is any ambiguity between the Constitution and this Handbook, the interpretation in the Constitution will apply.

Approval of the Handbook by the ICB Board will be on an annual basis. This will follow an annual review by the Director of Corporate Governance.

This version has effect from 01-07-2022.

2.0 NHS Core Values

2.1 The NHS Core Values are:

Respect and dignity:

We value each person as an individual, respect their aspirations and commitments in life, and seek to understand their priorities, needs, abilities and limits.  We take what others have to say seriously.  We are honest about our point of view and what we can and cannot do.

Commitment to quality of care:

We earn the trust placed in us by insisting on quality and striving to get the basics right every time: safety, confidentiality, professional and managerial integrity, accountability, dependable service and good communication.  We welcome feedback, learn from our mistakes and build on our successes.


We respond with humanity and kindness to each person’s pain, distress, anxiety or need.  We search for the things we can do, however small, to give comfort and relieve suffering.  We find time for those we serve and work alongside.  We do not wait to be asked, because we care.

Improving lives:

We strive to improve health and well-being and people’s experiences of the NHS.  We value excellence and professionalism wherever we find it – in the everyday things that make people’s lives better as much as in clinical practice, service improvements and innovation.

Working together for patients:

We put patients first in everything we do, by reaching out to staff, patients, carers, families, communities, and professionals outside the NHS.  We put the needs of patients and communities before organisational boundaries.

Everyone counts:

We use our resources for the benefit of the whole community, and make sure nobody is excluded or left behind.  We accept that some people need more help, that difficult decisions have to be taken – and that when we waste resources we waste the opportunities of others.  We recognise that we all have a part to play in making ourselves and our communities healthier.

2.2    The Nolan Principles

The Committee on Standards in Public Life (Nolan Committee) set out in 1995 seven principles of public life which should apply to all in public service –  The First Report of the Committee on Standards in Public Life, 1995.

These principles have been adopted as the basis for working practices across the ICB.


Holders of public office should act solely in terms of the public interest.


Holders of public office must avoid placing themselves under any obligation to people or organisations that might try inappropriately to influence them in their work.  They should not act or take decisions in order to gain financial or other material benefits for themselves, their family, or their friends.  They must declare and resolve any interests and relationships.


Holders of public office must act and take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias.


Holders of public office are accountable to the public for their decisions and actions and must submit themselves to the scrutiny necessary to ensure this.


Holders of public office should act and take decisions in an open and transparent manner. Information should not be withheld from the public unless there are clear and lawful reasons for so doing.


Holders of public office should be truthful.


Holders of public office should exhibit these principles in their own behaviour.  They should actively promote and robustly support the principles and be willing to challenge poor behaviour wherever it occurs.

2.3 Board Behaviours

Board Members should act with independence, rigour, integrity, probity, honesty and mutual trust and display high standards of individual and collective conduct.

ICB Members will maintain confidentiality and corporate responsibility. In addition, all ICB Members are required to:

2.4 Leadership Compact

The leaders of the organisations within the ICS have agreed to adopt the following attributes when working together.

  • Trust
  • Respect
  • Courage
  • Kindness & Compassion
  • Openness & Honesty
  • Looking Forward
  • Leading by Example
  • System First

3.0 ICB Vision and Values

Our vision is to make Staffordshire and Stoke-on-Trent the healthiest place to live and work.

This means:

  • Helping our population to live well, for longer, and supporting you to be as independent as possible.
  • Delivering Care as close to home as possible, ensuring that experience of health and care is the best it can be.
  • Treating people rather than conditions and giving mental health equal priority to physical health.

Our priorities are:

  • Improving outcomes in population health and health inequalities
  • Improving delivery of elective care services
  • Improving cancer services and outcomes in cancer care
  • Delivering improvements in Children and Young Peoples services and Maternity care
  • Improving Emergency Care and delivering more care at home
  • Promoting health aging and managing frailty
  • Delivering more services through Primary Care to support system transformation
  • Growing and improving Mental Health Services

4.0 ICB Governance Framework

4.1 Area covered by the ICB

The area covered by the ICB is the county of Staffordshire, including the city of Stoke-on-Trent.  We are responsible for the health and care of 1.1 million people who live in Staffordshire and Stoke-on-Trent, across a geographical area of 1,048 square miles.

We are aligned with two Upper Tier Local Authorities (UTLAs): Staffordshire County Council and Stoke-on-Trent City Council; and these Local Authority Districts (LADs) / Borough Councils: Cannock Chase, East Staffordshire, Lichfield, Newcastle-under-Lyme, South Staffordshire, Stafford and Staffordshire Moorlands.

4.2 Statutory Framework

The ICB is established by order made by NHS England under powers in the 2006 Act. The ICB is a statutory body with the general function of arranging for the provision of services for the purposes of the health service in England and is an NHS body for the purposes of the 2006 Act.

The main powers and duties of the ICB to commission certain health services are set out in sections 3 and 3A of the 2006 Act.  These provisions are supplemented by other statutory powers and duties that apply to ICBs, as well as by regulations and directions (including, but not limited to, those made under the 2006 Act).

In accordance with section 14Z25(5) of and paragraph 1 of Schedule 1B to the 2006 Act, the ICB must have a constitution, which must comply with the requirements set out in that Schedule.  The ICB is required to publish its constitution (section 14Z29). Find out more about the constitution.

The ICB must act in a way that is consistent with its statutory functions, both powers and duties.  Many of these statutory functions are set out in the 2006 Act, but there are also other specific pieces of legislation that apply to ICBs: examples include, but are not limited to, the Equality Act 2010 and the Children Acts.  Some of the statutory functions that apply to ICBs take the form of general statutory duties, which the ICB must comply with when exercising its functions.  These duties include but are not limited to:

4.3 Engagement and Involvement with local people and communities

Staffordshire & Stoke-on-Trent partners, working together as an Integrated Care System (ICS) are committed to understanding, listening to, and working with our people and communities to deliver the care and experiences that they deserve.

Find out more about the People and Communities Strategy

5.0 Support Policies

5.1 Standards of Business Conduct

The Staffordshire & Stoke-on-Trent Integrated Care Board (the ICB) will demonstrate the highest standards of corporate behaviour and responsibility.  This will be achieved through the adherence to the values described in the Nolan Committee Report and the standards for business & personal conduct in our Standards of Business Conduct Policy which all ICB colleagues will follow at all times.

Find out more about the Standards of Business Conduct Policy

5.2    Fraud, bribery and corruption

The Staffordshire & Stoke-on-Trent Integrated Care Board (the ICB) is committed to the proper use of public funds and their protection from losses caused by fraud, bribery, or corruption.  The ICB will seek to prevent and detect any such dishonesty and will take action to ensure that anyone who commits fraud or related offences either within or against the ICB is subject to all appropriate criminal, civil, disciplinary and regulatory sanctions.

Find out more about the Fraud Bribery & Corruption Policy

5.3 Freedom to speak up

Being able to raise concerns, without fear of recrimination and having them taken seriously and acted upon, is a vital requirement within the public sector and particularly within health care.  This is one of the tools which will enable staff to ensure services remain safe and responsive to patient’s need.

Find out more about Freedom to speak up policy

5.4 Standing Financial Instructions (SFIs)

The Standing Financial Instructions are intended to provide direction to staff and other stakeholders on all aspects of the ICB’s financial governance.

SFIs are an integral part of the ICB’s control environment for managing the ICB’s financial affairs as they are designed to ensure regularity and propriety of financial transactions.  They contribute to good corporate governance, internal control and risk management.  They enable sound administration, lessen the risk of irregularities and support commissioning and delivery of effective, efficient and economical services.  They also provide clear guidelines to the Chief Executive and the Chief Finance Officer to effectively discharge their responsibilities.

The SFIs incorporate the ICB’s delegated financial limits for the approval of transactions and financial decision making.

Find out more about SFI

5.5 Losses and special payments

Losses and special payments are items that Parliament would not have contemplated when it agreed funds for the health service or passed legislation.  By their nature they are items that ideally should not arise.  They are therefore subject to special control procedures compared with the generality of payments.

Find out more about Losses & special payments policy

5.6 Scheme of Reservation and Delegation

The Board of the ICB is responsible for all the decisions it makes, including those that it delegations to other to make on its behalf.  The Scheme of Reservations and Delegations set out which decisions (functions) the Board will delegate and which it reserves to make itself.

Find out more about the Scheme of Reservations & Delegation

5.7 Information Governance and data security and protection policy

This policy sets at the organisations overarching approach information governance. Information is one of our most valuable assets and it is vital that we know what information we hold, how we store it and how we use it.  This policy outlines these processes.

Find out more about Information Governance and Data Security & protection policy

5.8 Code of Conduct

The Code of Conduct supports the Information Governance and Data Security Policy by setting out out clear guidance standards for how staff manage and use information.

Find out more about Code of Conduct

5.9 Other policies

Please use the link below to access the ICB’s policies, which cover commissioning, complaints, and recruitment and selection.

Find out more about other policies

6.0 Functions and decisions map

A diagram outlining the connection between the Unitary Integrated Care Board and the Senior Leadership Team via the various Committees in place. The committees are listed in the page below from 8.1 to 8.5

7.0 Terms of Reference

Terms of reference (TOR) document establishes a board or committee and details the specific authority that the committee has to oversee a delegated area of responsibility. It includes the roles, responsibilities, operations, tenure and obligations, in accordance with any specific legislative requirements.

Find out more about Terms of reference

8.0 Audit Committee Terms of Reference

To contribute to the overall delivery of the ICB objectives by providing oversight and assurance to the Board on the adequacy of governance, risk management and internal control processes within the ICB.

The Audit Committee ensures that effective systems of integrated governance, risk management and internal control are maintained.

The Audit Committee also reviews the Risk Register and the Board Assurance Framework.

The sub-committees of the Integrated Care Board are responsible for overseeing the risks relating to their workstreams. The Audit Committee has oversight of all risks.

Click on this link to read the full Audit Committee Terms of Reference document in a new tab.

8.1 Remuneration Committee Terms of Reference

The Committee’s main purpose is to exercise the functions of the ICB relating to paragraphs 17 to 19 of Schedule 1B to the NHS Act 2006.  In summary:

Confirm the ICB Pay Policy including adoption of any pay frameworks for all employees including senior managers/directors (including board members) and non-executive directors, excluding the Chair:

Find out more about Remuneration Committee Terms of Reference

8.2 Finance and Performance Terms of Reference

The role of the Committee is to advise and support the Board in scrutinising and tracking delivery of key financial and service priorities, outcomes and targets as specified in the ICS Strategic and Operational Plans.

Find out more about Finance and Performance Terms of Reference

8.3 Quality Committee Terms of Reference

The Committee exists to scrutinise the robustness of, and gain and provide assurance to the ICB, that there is an effective system of quality governance and internal control that supports it to effectively deliver its strategic objectives and provide sustainable, high-quality care.

It will also provide the ICB with assurance that it is delivering its functions in a way that secures continuous improvement in the quality of services, against each of the dimensions of quality set out in the Shared Commitment to Quality and enshrined in the Health and Care Bill 2021.

Find out more about Quality Committee Terms of Reference

8.4 People, Culture & Inclusion Committee Terms of Reference

The Committee will seek to act in the best interest of citizens, patients, our people and the system as a whole by providing innovative strategic People solutions which will address the cultural changes that are necessary to build a workforce that befits a world-class 21st century health and care system which is recognised as being the best place to work.

Find out more about People, Culture & Inclusion Committee Terms of Reference

For more information, you can explore our Governance Handbook Documents.