Intended for healthcare professionals


Hospital staff governors: what they do and why you might want to be one

BMJ 2017; 356 doi: (Published 16 January 2017) Cite this as: BMJ 2017;356:j76
  1. George Collins, core medical trainee,
  2. Fraz Mir, consultant physician
  1. Cambridge University Hospital NHS Foundation Trust
  1. collinsgeorge{at}


George Collins and Fraz Mir discuss the role of the hospital staff governor and the benefits of taking on the position yourself

The council of governors is a group of volunteer patients, public, and staff tasked with holding foundation trusts to account.

Foundation trusts must form and support a council, and the council holds the executive board of the trust to account for its performance through the non-executive directors who sit on the board. The non-executive directors act as informed, independent, critical advisors to the executive directors. The chair of the foundation trust also chairs the council of governors.

The council of governors is made up of volunteer governors elected from three constituencies—patients, public, and staff—as well as nominated representatives from local partnership organisations such as universities and local councils. The council of governors is an important and powerful platform that gives these groups a voice within foundation trusts.

Individual governors must understand, interpret, and communicate clearly the issues facing the people they represent and channel that information back to their constituents. Governors must also be able to interrogate foundation trust strategy and question the non-executive directors appropriately and robustly.

What do staff governors do?

Staff governors act as a conduit between hospital management and its employees. They interpret issues on both sides from each perspective. Staff governors regularly study board reports, survey and give feedback to employees, and reflect on local issues within national contexts to bring to light unaddressed staff views. Ultimately, they hold the non-executive directors to account for the performance of the trust board.

In our experience, foundation trust staff greatly value staff governors’ insights and having their own views represented at a board level. Equally, executive directors often look to staff governors to help with issues such as recruitment, retention, and staff engagement.

Staff governors complement, but do not duplicate, the work of trade unions, staff councils, and other professional bodies. Most importantly, they offer the council of governors a view into the front line workings of the NHS, reporting back directly from staff.

Governors are elected by popular vote and sit for two to three years pending re-election. Their main duties play out in the quarterly council of governors meetings. To do everything expected of them requires at least two to three days a month, for which professional paid leave may be available.

Governors have a comprehensive local induction and can attend optional, but advisable, GovernWell training days to learn more about their role and discuss their experiences with other governors. Many important transferrable skills are learned throughout the process.

Why become a staff governor?

In our experience clinicians are underutilised but valuable members of the council of governors. They are the “ears” to the hospital ground and their understanding of front line medicine, combined with the real life boardroom experience of being a governor, provides an asset to trust-wide communication, progress, and morale in general.

At an individual level, staff governors gain practical management experience, a rare insight into managerial hierarchies and staff perspectives, and a heightened sense of professional wellbeing. There is fulfilment in working voluntarily to contribute positively to trust strategy and the working lives of others. The role adds weight to job applications and may also lead to more senior foundation trust positions. The experience of being a staff governor, while often challenging during difficult times, can be very rewarding for individuals prepared to take the plunge.

Who should stand for election as a staff governor?

Applicants should have enough experience of the hospital to be familiar with its staff and workings. They should be accessible, enthusiastic, forward looking, engaged, and hard working, as well as diplomatic, pragmatic, time efficient, and confident. They must have an interest in the welfare of all staff and a genuine reason to represent them. The time and energy needed should not be underestimated, but if you want to make a difference at the trust level, standing for this post is worth considering.

Clinicians are under-represented, but valued, members of the council of governors with much to contribute. The first ports of call for advice would be the foundation trust secretary or previous staff governors.


  • We thank Jane Pigg, company secretary at Peterborough and Stamford Hospitals NHS Foundation Trust, and Mike More, chair of the council of governors at Cambridge University Hospitals NHS Foundation Trust, for reading early drafts of this article and suggesting modifications and additions.

  • Competing interests: We have read and understood BMJ’s policy on declaration of interests and declare the following interests: GC was a staff governor at Peterborough and Stamford Hospitals Trust and FM is a staff governor at Cambridge University Hospitals Trust.