Well-led · KLOE 4

Governance

Are there clear roles, responsibilities and systems of accountability to support good governance?

CQC wording, primary care and community services draft V6.0, pages 52 to 54.

Draft, not the current assessment framework

CQC's primary care and community services draft V6.0, published March 2026. The current quality statements remain in use.

CQC draft scope

What this proposed KLOE covers

Scope of this key line of enquiry and topic areas include:

The draft applies one framework across primary care and community services, but useful evidence depends on your service and people.

Source: CQC, Primary care and community services assessment framework, draft V6.0, 19 March 2026, pages 52 to 54. Contains public sector information licensed under the Open Government Licence v3.0.

CQC draft rating characteristics

These are CQC's draft characteristics. CQC says rating characteristics guide judgements, they are not a mechanical checklist.

Governance arrangements explicitly support the delivery of high-quality, safe and equitable care. They are clear, coherent and enable effective decision making, accountability and delivery of the organisational strategy.
Governance systems are proactively reviewed to ensure they remain fit for purpose, proportionate and responsive to emerging risks, system changes and population needs.
Governance structures operate with clear purpose and are supported by well-defined authority to make decisions, escalation routes and accountabilities. These are consistently understood across the service and routinely tested through real-time issues and learning.
Governance systems are inclusive and empowering. The service demonstrates a learning-focused governance culture, where insight from staff, people who use services and partners informs action and improvement.
Governance of partnerships, joint working arrangements and shared services is rigorous and mature, with clear shared objectives, defined accountabilities and joint risk management. The organisation plays a leading role in the wider health and care system by supporting collaboration that delivers improved health and care outcomes.

There are clear and effective governance arrangements, including those to ensure compliance with any legal requirements and duties.
Governance structures, roles and responsibilities are understood across the service and are regularly reviewed to ensure they are fit for purpose.
Structures, processes and systems of accountability, including the governance and management of partnerships, joint working arrangements and shared services, are clearly set out, understood and effective.
Staff understand their roles and responsibilities. Managers and leaders are accountable for their own actions, behaviours and performance, and for those of their staff.
Governance arrangements support the delivery of safe, effective and equitable care, including implementing relevant quality frameworks, recognised standards and best practice.
Leaders implement all relevant quality frameworks, recognised standards and best practice and use these to tackle known inequalities and to improve equity in experience and outcomes for people using services.

The organisation’s governance, management and accountability arrangements are not clear or do not always operate effectively.
Governance, accountability and management arrangements to ensure compliance with any legal requirements and duties are not always effective. There has been no recent review of the governance arrangements, organisational strategy, values, objectives or plans.
Staff are not always clear about their roles and responsibilities, what they are accountable for, and to whom. Managers and leaders cannot routinely account for their own actions, behaviours and performance, and for those of their staff.

The organisation’s governance arrangements and their purpose are unclear. There is a lack of clarity about authority to make decisions and how individual members of staff are held to account.
Governance, accountability and management arrangements to ensure compliance with any legal requirements and duties are ineffective.
There is no process to review the governance framework.
Staff and their managers are not clear on their roles or responsibilities.
Accountability mechanisms are weak. There is a lack of systematic performance management of individual members of staff, or appropriate use of incentives or sanctions.

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