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Clinical GovernanceClinical Governance is the term used in the United Kingdom National Health Service (NHS) and private healthcare system to describe a systematic approach to maintaining and improving the quality of patient care. The most widely cited formal definition describes clinical governance as "A framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish."
(Scally and Donaldson, 1998) This definition is intended to embody three key attributes: recognisably high standards of care, transparent responsibility and accountability for those standards, and a constant dynamic of improvement. The concept has some parallels with the more widely known Corporate Governance in that it addresses those structures, systems and processes that assure the quality, accountability and proper management of an organisation's operation and delivery of service. However clinical governance applies only to health and social care organisations, and only those aspects of such organisations that relate to the delivery of care to patients and their carers; it is not concerned with the other business processes of the organisation except in so far as they affect the delivery of care. The concept of "integrated governance" has emerged to refer jointly to the corporate governance and clinical governance duties of healthcare organisations. Prior to 1999, the principal statutory responsibilities of UK NHS Trust Boards were to ensure proper financial management of the organisation and an acceptable level of patient safety. Trust Boards had no statutory duty to ensure a particular level of quality. Maintaining and improving the quality of care was understood to be the responsibility of the relevant clinical professions. As of 1999, Trust Boards assumed a legal responsibility for quality of care that is equal in measure to their other statutory duties. Clinical Governance is the mechanism by which that responsibility is discharged. "Clinical Governance" does not mandate any particular structure, system or process for maintaining and improving the quality of care, except that designated responsibility for clinical governance must exist at Trust Board level, and that each Trust must prepare an Annual Review of Clinical Governance to report on quality of care and its maintenance. Beyond that, the Trust and its various clinical departments are obliged to interpret the principle of clinical governance into locally appropriate structures, processes, roles and responsibilities. References G Scally and L J Donaldson, 'Clinical governance and the drive for quality improvement in the new NHS in England' BMJ (4 July 1998): 61-65 External Links *UK NHS Clinical Governance Support Team
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