Governance · Standards
International Standards Council
Oversees the development, maintenance, and revision of all ASF standards. Independent of ASF operations. Every criterion requires a cited evidence base before adoption.
Role
- Approves all new criteria and any changes to existing criteria
- Manages the six-step revision process
- Ensures each criterion has a cited evidence base before adoption
- Mandatory equity review — assessing applicability across income tiers — on all proposed changes
- Manages the standards appeals procedure
- Publishes the annual standards activity report
- Conflict of interest register published publicly — updated within 30 days of any change
Composition
| Rule | Detail |
|---|---|
| Size | Minimum 7 members |
| Disciplines | Different clinical disciplines, facility types, and geographic regions |
| Independence | Majority must have no financial interest in ASF-accredited facilities |
| Conflict of interest | Full register published and updated publicly |
| Patient representation | At least one member with patient safety or patient experience background |
The Six-Step Revision Process
| Step | What happens | Who is responsible |
|---|---|---|
| 1. Proposal | Any party (facility, Monitor, Coordinator, Patient Council, external expert) may submit a proposed change with evidence | Submitter + Standards Council secretariat |
| 2. Evidence review | Standards Council reviews the evidence base; commissions independent clinical review if needed | Standards Council |
| 3. Equity assessment | Mandatory assessment of applicability across income tiers and healthcare system types | Standards Council + external reviewer |
| 4. Public consultation | Minimum 30-day public comment period managed by the Patient and Public Council | Patient and Public Council |
| 5. ADC review | ADC reviews proposed change for consistency with accreditation decision practice | ADC |
| 6. Adoption | Standards Council votes. Simple majority for minor changes; two-thirds for changes to Non-Negotiable criteria | Standards Council |
Standards Appeals
Any facility, Monitor, Coordinator, or member of the public may appeal a standards decision. Appeals are reviewed by a three-member panel, none of whom sat on the original decision. Decision within 90 days. Published in the annual standards activity report.
House of Lords, London, 2019 — ASF standards methodology presented to international policy audience
Parliamentary committee, Georgia — standards review in national health governance context