Problem B - governance doesn't seem to be adding much value
A session with the governing body using the maturity matrix would be a useful first move to establish a common agreement in the CCG leadership around the areas where the hoped for outcomes of good governance are not being achieved.
This could usefully be followed by a peer review exercise with another CCG to explore key points where improvements could be made. If the peer review could be organised to focus on areas of both strength and weakness, this would enable a productive two-way learning process with the peer reviewing CCG.
As a supplement or an alternative to the peer review, the observation tool could be useful to surface some of the issues with decision-taking by targeting both the governing body meetings and some of the supporting committee discussions.