Clinical governance is a very complex approach to outline the maintenance and improvement of patient healthcare.Clinical governance has its roots in the increasing number of deaths due to pediatric surgery at the Bristol Royal Infirmary during 1995…
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Since then National Health Service (NHS) has been active in defining and outlining best practices for clinical governance in order to improve the delivery of overall health care to patients. Clinical governance as a mechanism therefore emerged in order to improve the overall healthcare standards in NHS organizations. It not only makes organizations accountable but also put through a systematic process of improving the overall quality at the health care service providers. By implementing the concepts of clinical governance, NHS therefore attempted to introduce a radical framework to improve the quality of health care on consistent base. The overall model of clinical governance is based upon certain components and critically following all the standards and criteria mentioned under such components also need to be followed. By opening up the overall clinical governance to the public scrutiny also increases the element of accountability and makes it mandatory for NHS trusts to actually look for continuous improvement of the system. This paper will present a literature review on the clinical governance and two of its important components i.e. clinical audit and evidence based practice. By providing a review and critique of the existing literature, this paper will discuss how clinical governance can be evaluated in the extended scope of practice. Clinical Governance Clinical governance is considered as an umbrella term used to define the broader level of standards to sustain and improve the overall health care standards for patients. First introduced through a Government Whitepaper, clinical governance was advocated as a new system within NHS Trusts to ensure that all the clinical standards are met and that effective processes are in place. The new system was believed to be rapidly evolving and it was expected that the improvements will be incremental and that the future will be reasonable enough to predict that NHS trusts will be able to maintain and improve their performance. (Badham, Wall, Sinfield & Lancaster, 2006) The origins of term clinical governance can be traced back to the White Paper “The new NHS Modern, dependable”. This document was also considered as the overall vision and plan of labor government to actually improve the quality of healthcare services and improve the ability and capability of NHS to deliver such quality services. (Nicholls, Cullen, & O’Neill Halligan, 2000). Its origins are in that of the corporate governance and Cadbury Report on Corporate governance served as one of the key strategic inputs in developing a comprehensive framework for clinical governance.( Maxwell, 1984) It is also critical to note that the term clinical governance, as initially defined in the original White Paper has actually changed. It has now assumed a global acknowledgment and most of the clinicians have actually embraced clinical governance as a recognized framework. Differences however have emerged in terms of how clinicians have actually internalized the term in relation to their specific profession. These differences in the overall perception of what actually clinical governance is and how it can be properly implemented therefore may not result into development of specific models or standard frameworks for corporate governance. (Halligan, Wall, & O’Neill, 2002) Clinical governance actually puts in new statutory responsibility on the NHS and its trusts to actually put in place an established framework for improving quality of healthcare service. There were three important elements which were basically to be implemented and improved upon i.e. safeguarding of the standards, promotion of continuous improvement and overall encouragement of the excellence. (Hothi, 2004) Introduction of clinical governan
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