An Operating Framework has been developed and is used by all 12 Clinical Senates in England to deliver their non-statutory clinical advisory service for commissioners, including the role they play in contributing to the NHS England assurance process in major service change.

Accountability and Governance

Clinical Senates are a non-statutory organisational model for the provision of independent strategic clinical advice and clinical leadership. Within this model, commissioners, the CCGs and NHS England, remain accountable for the commissioning of services and the providers are accountable for the quality of service delivery.

Each Clinical Senate Support Team will have overall management responsibility for the delivery of the Clinical Senate function of their geographical area and are funded by and accountable to NHS England.

The Clinical Senate Chair is accountable for ensuring that the Senate is a credible and respected source of safe, evidence based, independent strategic clinical advice and the Chair will also ensure that the Clinical Senate is able to demonstrate how they have applied the guiding principles in the formulation of their advice.

NHS England allocates funding and assures use of that funding and business processes employed by each Clinical Senate.  NHS England appoints the Chair and the support team.

Each Senate Council assures itself that it is compliant with minimum requirements to deliver senate business as set out below.

  • Council membership recruited and meeting at least quarterly
  • Clinical Assembly established and process for establishing the assembly documented
  • Citizen representative(s) on Senate Council
  • Agreed and up to date transparent decision making process
  • Agreed and up to date terms of reference including method of collaboration with other clinical senates
  • Agreed and up to date process for requesting and delivering clinical advice that clearly describes how the council sources advice from the assembly
  • Agreed and up to date conflict of interest policy, declaration of interests process and maintained register
  • Agreed and up to date process for running independent clinical review teams that support the NHS England assurance process
  • Annual Report published
  • Digital communication platform with published clinical advice