CLINICAL GOVERNANCE

From the NHS primary care website

 Department of Health (1998) A First Class Service: quality in the new NHS.

See the enclosed document "What is Clinical Governance?"

Whilst people working in the NHS strive to achieve good quality of care, sometimes results fall short of aspirations. Clinical governance is intended to be an open and helpful process, embracing all members of clinical teams and helpful to those who are falling behind in delivering best care. It will help to identify poor performance and, in part, tackle all issues causing poor performance although it may be necessary to use other contractual and regulatory methods at times.

We all realise that not everything can be achieved at once. That is why Primary Care Group guidance suggested that new PCGs should concentrate on one national and one local issue to develop governance techniques, as well as service improvements, in their first year. The choices of national issues were from

• antibiotic prescribing
• coronary heart disease
• cancer services
• mental health

Local issues might, for example, be contraceptive services, if there is a major problem of teenage pregnancy, or asthma, if there is a feeling that people with asthma are not getting the best care.

The four key tasks for PCGs in the first year, as described and explained in the guidance accompanying HSC(99)065 are;

• Establish leadership, accountability and working arrangements
• Carry out a baseline assessment of capacity and capability
• Formulate and agree a development plan in the light of the assessment
• Clarify reporting arrangements for clinical governance within Board and Annual reports

Principles of Clinical Governance

The main components of clinical governance are:

• clear lines of responsibility and accountability for the overall quality of clinical care;
• a comprehensive programme of quality improvement systems (including clinical audit, supporting and applying evidence-based practice, implementing clinical standards and guidelines, workforce planning and development);
• education and training plans;
• clear policies aimed at managing risk;
• integrated procedures for all professional groups to identify and remedy poor performance.

Further Information & Links

• Clinical Governance support team

The CGST is working to help you implement clinical governance. We offer practical support through our development programmes, information about clinical governance, lessons from development work across the country and a place to find answers to your clinical governance questionsimproving the quality of their services and safeguarding high standards of care by creating an environment in which clinical excellence will flourish

Clinical Governance resource pack on the wisdom site

• Quality Assessment for General Practice; supporting clinical governance in PCGs. This document, published by the National Primary Care Research and Development Centre gives details of a number of other internet and paper resources to support clinical governance. It is available on the Internet at www.npcrdc.man.ac.uk/.
  
   
• An NHS Web site has been launched to enable local services and interested staff to interact, share good practice and access information from other websites. the address is nww.doh.nhsweb.nhs.uk/nhs/clingov.htm
  
   
• The Phoenix Agenda is a project commissioned by the NHS Executive Development Unit. The objectives of the project are:
   
  • to develop and publish national development frameworks for management and leadership within primary care (including General Practice / Primary Care Groups and Primary Care Trusts)
  • identification and promotion of best practice in primary care management education, training and development
  • a national communication network to link individuals and groups involved in training and development within primary care.

   

•  See Clinical Effectiveness and Clinical Governance made easy by Ruth Chambers and Elizabeth Boath