The Council of Governors consists of 14 public governors, six staff governors and seven partner governors. The partner governors were appointed to represent their organisations – London Borough of Hackney, City Corporation, NHS City and Hackney Primary Care Trust, Queen Mary College of the University of London and City University. Registered members of Homerton University Hospital NHS Foundation Trust elect public and staff governors by an election administered by the Electoral Reform Ballot Service.

The sub-committees of the Board are the Audit Committee, Quality Improvement Committee, Risk Committee, Workforce Committee, Finance Committee and Patient & Public Involvement and Membership Development Committee.

The responsibility for clinical management and leadership is delegated to the Clinical Board, comprising of the executive directors and clinical directors. Clinical care is the responsibility of clinical teams divided into the clinical directorates of:

• Surgery, women's and sexual health services
• Children's services, diagnostics and outpatients
• Integrated medical and rehabilitation services

The Standing Orders, Standing Financial Instructions, Terms of Reference of Sub-committees and other corporate information relating to the conduct of Trust business outline how the Trust operates. These and the Foundation Trust Authorisation documentation are held by the Trust Secretary.