NHS trust board good governance maturity matrix

August 2017

The NHS trust board good governance maturity matrix is designed to help NHS trust boards to self-assess whether they are achieving the expected desirable outcomes of good governance practice.

The maturity matrix describes twelve key elements of good governance practice along the y-axis, and graduations of ‘maturity’ along the x-axis. For each of the key elements, we have identified indicative statements so that an NHS trust board can self-assess its level of maturity. The matrix can be used to both agree current status as well as developmental expectations of the board. As an example, a trust board may identify that it is currently at ‘early progress’ stage in regard to ‘measurement and integrated reporting’, and aspires to reach ‘results’ within a 12-month period.



In most cases, an NHS trust will not be at the same level for all elements of good governance practice described within the matrix. If the board feels as though it has not reached level 1 (basic level), this should be indicated as a ‘no’ (level 0) on the matrix.

There are a number of ways this matrix can be used by NHS organisations: 

  • as an assessment tool to agree current status
  • as a developmental tool at a board development workshop, whereby members of the board could ‘vote’ where they felt the trust is on the matrix and then, through a facilitated discussion, agree a group decision about current scorings and developmental aspiration within a given timeframe 
  • as a benchmarking tool to enable the comparison of NHS organisations and to identify examples of good practice that other NHS trusts could learn from
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Christopher Smith

Christopher Smith


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