Board assurance tools help a Board to focus on the key questions and tensions they must address. They are useful in supporting:

• New Board members as part of their induction

• Authors of Board papers in suggesting key questions the Board might address

• A strategic rather than operational focus on issues

• The Board to review its performance.

The Board has a responsibility to ensure the short and long term viability of the organisation. This requires us to assure that the trend data and financial information we receive is robust, that we compare ourselves appropriately with other organisations, maintaining the quality of the services we deliver. We need to continuously modernise our service delivery and ensure sustainable efficiency gains.

1. Have we aligned our capital investment plans with our strategy, are they supporting sustainable sector plans and national directives?

2. Do we know what proportion of our budget is being spent on achieving key objectives and how much on other things?

3. Do we know the costs of delaying or not proceeding with any of our plans?

4. Do we use a wide enough range of audits and indicators to validate our understanding of the financial position?

5. How do we assure ourselves our financial data is robust?

6. Are we clear where the Trust stands in national and international benchmarks of costs and on PbR?

7. How do we ensure we engage a wide enough range of people and opportunities such as benchmarking, partnerships, service re configuration, and organisational learning when making efficiency improvements?

8. How do we demonstrate leadership in ensuring efficiency gains from new ways of working?

9. How do we effectively engage clinicians on the efficiency agenda?

10. How do we reconcile the need to deliver prescribed levels of service with the savings required to achieve budget?

Providing service quality	vs.	Delivering sufficient financial margin
Supporting the strategic plan	vs.	Balancing the books
Delivering long term benefits	vs.	Meeting urgent needs
Devolving responsibility	vs.	Retaining control
Planning to meet national and sector needs	vs.	Pursuing our specific goals