Here at Healthcare Governance Review we thought that ‘clinical governance’ had fallen out of favour at the Department of Health (DH), what with no real mention of it in Lord Darzi’s approach to improving quality in the NHS.
On 20 March 2009, however, the DH published a major report Tackling Concerns Locally, supported by several ‘subgroup reports including one by the ‘Clinical Governance subgroup’.
Tackling Concerns Locally, together with its supporting reports, sets out the principles of best practice on how local systems for clinical governance could be strengthened to promote continuous improvement in the quality of care and enable healthcare organisations to identify and deal with those healthcare professionals whose performance, conduct or health could put patients at risk.
According to the report of the Clinical Governance subgroup, “Boards have a corporate duty to ensure that the processes for clarification and investigation of concerns about performance, conduct and health are carried out in a consistent and fair way and to ensure that the individuals involved in the process are appropriately trained, supported and resourced to do so.
The Clinical Governance subgroup also looks at clinical governance in a wider context. “Good clinical governance and patient safety” they say “is part of a culture that is led by the Board but implemented by the actions of individuals and is the responsibility of all of those within the organisation…….Where an organisation has strong governance processes, the whole clinical governance spectrum can be seen to be working effectively to both assure the quality of individuals working within the system and to ensure that poor performance is identified and managed appropriately.”
They go on to say that “The Board and its leaders are accountable for the actual and potential issues that affect the quality of the services provided and will soon be required to provide an annual ‘quality account. The Board should strive to build and maintain such a supportive clinical governance culture and have processes that are monitored to assure itself that the healthcare organisation is identifying, investigating and taking action to deal with and learn from patient safety and quality concerns.
In support of their assertions, the Clinical Governance subgroup helpfully specifies, in chapter 2 of their report, the generic ‘components’ of a clinical governance framework in all healthcare organisations in relation to Tackling Concerns Locally. The components are arranged into the following ‘dimensions’ of clinical governance:
– Corporate, clinical and information governance of organisation
– Culture: leadership, teamwork and communication
– Patient safety, risk management and incident reporting
– Feedback and involvement from users and stakeholders
– Quality improvement and service development, focus on clinical and service outcomes
– Use of information
– Educational and supportive ethos, effective appraisal systems supportive ethos, effective appraisal systems
Download the main report Tackling Concerns Locally, together with the clinical governance and other sub group reports here.
Access background information on the Tackling Concerns Locally project here.