Guidance for foundation trust governors which appears to suggest they should go straight to the Care Quality Commission with any concerns is adding to growing confusion over their role, HSJ has been told.

The CQC and the Foundation Trust Governors Association published a joint leaflet earlier this year on how governors can work with the CQC. It encourages governors to make unannounced visits and suggests they could share the minutes of meetings with their “CQC manager”.

The guidance notes that governors have increased responsibilities to hold their trust to account under the 2012 Health and Social Care Act. This makes it “even more important that CQC and councils of governors work together”, it states.

However, chairs and chief executives are concerned the leaflet is advocating an overly antagonistic relationship between councils of governors and their boards.

One foundation trust chair told HSJ there was “real confusion” as to the role of governors.

She said: “What we want governors to do is to be in the community both as an advocate for the hospital and to pick up understanding and intelligence from public where there are issues.

“The CQC seem to be looking for governors to be their eyes and ears on the ground and have some sort of direct relationship with them, when their relationship in the first instance should be with the trust.”

Foundation Trust Network chief executive Chris Hopson told HSJ he had picked up “growing concern” from trusts over the past few months that there were different views in the system about the role of governors.

Mr Hopson said conflicting advice from different organisations, on top of the changes introduced by the 2012 health act, seemed to be adding to concerns. He said the FTN had been working with Monitor, the FTGA and the CQC to develop a shared view of the role of governors. It is expected to be published by the autumn.

A joint statement from the CQC and the governors association said the guide stressed “the importance of governors working with their trust boards in the first instance”.

It added: “CQC would clearly not expect governors to do anything to gather or provide information to CQC that is not part of their routine governor responsibilities. It is at the discretion of governors, as a collective council, to decide whether and what information they wish to share with CQC.”

Under the health act the council of governors has a new legal duty to hold the non-executive directors to account, as well as rights of approval on significant transactions, plans for merger or acquisition, and proposals to increase private patient income by 5 per cent or more in one year.