The Board of Directors at Queen West provides strategic and fiduciary leadership to the organization through the fulfillment of legal, political, planning, financial, and community liaison responsibilities to Queen West. The Board enacts its role and responsibilities through the articulation of a vision, mission, values, strategic plan, and appropriate policies.

The board of Queen West is a policy board as distinct from other models of governance such as a working/administrative board or policy governance (Carver) board.

The Board is elected at an Annual General Meeting, normally held each September, from candidates nominated from and/or approved by the membership. The Board strives to achieve a balanced representation, comprised of representatives from priority-group health care consumers; health care providers; persons with health policy, managerial and labour relations experience, preferably in health or social services; and the community.

The Board governs in accordance with legislation governing non-profit charitable corporations and their Directors; applicable federal, provincial and municipal laws, regulations and orders, rules and by-laws having the force of law; the Articles of Incorporation and By-laws of the organization; Ministry of Health and Long Term Care Policies and Guidelines; and any directives from the Central Toronto Local Health Integration Network.

The operations of the organization is managed by an Executive Director and a team of program Directors.