Clinical Governance

Quality of care is a major topic in health and social care, and clinical governance ensures this quality is maintained to a high standard. 

What is clinical governance?

Scally and Donaldson wrote ‘Clinical governance and the drive for quality improvement in the new NHS in England’ in 1998, covering a definition for clinical governance:

“A system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.”

It’s essentially an overarching framework covering all activities that help sustain and improve high standards of patient care. Health care organisations must be able to evidence that standards are maintained when putting any structures, systems or processes in place. 

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1. Clinical Effectiveness

Any treatment used must provide the best outcome for the patient:

  • Using evidence based approaches when deciding treatment
  • Sticking to guidelines
  • Using experience to improve
  • Researching to enhance future care

2. Risk Management

Minimise risks to the patients in care. There are different ways to manage risk and ensure incidents don’t occur:

  • Identifying problem areas in treatments
  • Improvement through learning from previous issues
  • Reduce risks by implementing risk systems
  • Thorough risk assessments and reporting of incidents and near misses

3. Patient & Public Involvement

Communicate with patients and the public to gain insight on the quality of care and any possible problems:

  • Patient questionnaires
  • Patient forums
  • Representatives for patients on practice and hospital boards

4. Audit

Audits are carried out to monitor the quality of clinical care being carried out. They measure against set guidelines and any deviances are examined and improved upon. After some time, audits are repeated to ensure that actions taken to improve have worked, and organisations are quality assured.

5. Staff Management

This ensures those employed are suitable to carry out the work. If anyone is under performing, they can be highlighted and helped to improve. Professional development of staff should be encouraged, and this can be helped through motivation and a pleasant working environment. 

6. Education & Training

It’s important staff have continual training to ensure they are up to date in their knowledge. This allows them to provide the best care possible at all times. Staff can:

  • Achieve further education through degrees or diplomas
  • Attend events, lectures, webinars, and courses

7. Information

A patient’s information should always be up to date and correct on any systems used. It should also be confidential through correct storage and management of data.

Why are the 7 pillars of clinical governance important?

Clinical governance ensures a continuous drive to improve standards of health and social care organisations. A cycle of controlling, monitoring and improving through the 7 pillars ensures a higher quality of care for patients.

Published by Bevamed

Professional Bio John Dunn, FRSPH, CMgr FCMI John Dunn is an accomplished Offshore Medic, Public Health Practitioner and Strategic Health Operations Advisor with over 25 years’ experience across maritime, offshore energy, humanitarian and international environments. He is recognised for his rare blend of autonomous clinical capability, operational leadership and advanced public health expertise bringing safety, resilience and health protection to some of the world’s most complex and remote settings. Holding a Master of Public Health (MPH) with Outstanding distinction, alongside a Doctor of Business Administration (DBA) and Global MBA, John operates at the intersection of frontline healthcare, population health and strategic decision‑making. His career spans NHS emergency care, offshore installations, cruise and expedition vessels, major infrastructure projects and high‑risk international deployments. John has led infection prevention & control, outbreak management, hygiene assurance, environmental health, and communicable disease control across closed, remote and multicultural populations. His offshore and maritime work includes medevac coordination, emergency response, chronic disease management and maintaining vessel sanitation standards in accordance with CDC VSP and SHIPSAN principles. Across global assignments including the Fehmarn Belt Project and international COVID‑19 operations, John has strengthened health protection systems, coordinated multi‑agency responses and supported operational continuity in resource‑constrained environments. His humanitarian work includes a widely recognised international medical repatriation mission acknowledged by Windsor Castle for compassion and exceptional service. A Chartered Fellow of the Chartered Management Institute (CMgr FCMI) and Fellow of the Royal Society for Public Health (FRSPH), John brings governance‑led thinking, ethical practice, and evidence‑informed judgement to every assignment. He is highly experienced in training and mentoring multidisciplinary teams, delivering emergency drills and supporting organisational resilience. John is available for offshore, maritime, global health, public health protection, and strategic advisory roles, offering a unique combination of clinical autonomy, operational insight and public health leadership.

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