The Ukrainian healthcare system is gradually transitioning to a new model of governance for medical institutions. The introduction of supervisory boards will become an important element of this transformation.
From 2027, the presence of a supervisory board will be a mandatory condition for contracting with the NHSU under the Medical Guarantees Program for cluster and super-cluster hospitals. From 2028, this requirement will apply to all institutions providing specialized medical care.
For many medical institutions this means not simply creating a new governance body, but an actual change in governance culture. Therefore hospital directors should start preparing already now.
Below are key steps that should begin today.
1. Conduct an audit of the governance system
The first step should be an internal audit of management processes. It is important to evaluate how strategic decisions are made, how financial reporting is formed, whether internal control mechanisms exist, and how transparent procurement and use of funds are.
The supervisory board will work precisely with these processes, therefore their transparency and structure must be ensured in advance.
2. Update internal regulations of the institution
The introduction of a supervisory board will require revision of key internal documents, including:
· regulations on management of the institution;
· financial control procedures;
· rules for the use of charitable funds;
· procedures for reviewing patient complaints;
· staff bonus and motivation systems.
These documents must be clear, transparent, and comply with modern governance standards.
3. Develop a clear hospital development strategy
One of the main functions of supervisory boards will be approval of strategic development plans. Therefore medical institutions should have:
· a clear vision of hospital development for 3–5 years;
· a financial model of this development;
· priority investment areas;
· a plan for infrastructure modernization.
Without a strategic plan, interaction with the supervisory board will be significantly more difficult.
4. Prepare a financial transparency system
Supervisory boards will pay special attention to financial management. Therefore it is important to:
· structure financial reporting;
· introduce regular internal financial reviews;
· clearly separate budgetary and charitable funds;
· ensure transparency of procurement.
This will not only simplify the work of the supervisory board but also increase trust in the institution.
5. Introduce ethics and conflict-of-interest prevention policies
In modern healthcare governance systems, integrity policies play an important role. Key elements include:
· conflict-of-interest declarations;
· a code of ethics for management and staff;
· rules for cooperation with charitable foundations and donors;
· a transparent mechanism for responding to violations.
The presence of such policies greatly simplifies the work of supervisory bodies.
6. Build a communication system
The introduction of supervisory boards will change the structure of decision-making. Therefore it is important to determine in advance:
· how interaction between the director and the supervisory board will be organized;
· how materials for meetings will be prepared;
· how decisions will be recorded;
· who will be responsible for their implementation.
A clear communication system will help avoid managerial conflicts.
7. Prepare the management team for the new model of work
Supervisory boards change not only the management structure but also the culture of work of medical institutions.
This means a transition from personalized management to institutional governance.
Therefore it is important to involve the management team in the preparation process, explain the new system of powers, and form a culture of strategic planning and accountability.
Although mandatory introduction of supervisory boards will begin only in 2027, preparation requires time.
In fact, this is about transitioning to a new model of hospital governance — more transparent, strategic, and accountable.
Medical institutions that begin preparation now will gain an important advantage: they will adapt to the new system without managerial shocks and use the reform as an opportunity for development.
