Realising the developmental potential of Clinical Governance

Abstract

To be effective, Clinical Governance should reach all levels of a healthcare organisation. It requires structures and processes that integrate financial control, service performance, and clinical quality in ways that will engage clinicians and generate service improvements. The Clinical Governance arrangements of many Trusts, however, present several flaws. In particular, the "silos" organisational structure of Clinical Governance is based on generic issues such as risk management, clinical audit, clinical effectiveness and staff development, and it tends to treat clinical work as an undifferentiated aggregate. An alternative model focused on clinical pathways and on a balance between professional autonomy and accountability (responsible autonomy) should be promoted to make Clinical Governance work.