What is Clinical Governance? Understanding the basics

What is Clinical Governance? Understanding the basics 

‘Clinical governance is a systemic approach to maintaining and improving the quality of patient care with in a health system’ (NHS) The key concepts of clinical governance include; recognising high standards of care, a transparency and accountability for those standards and a commitment to continuous quality improvement.

What are the elements of clinical governance?

  • 1. Leadership
  • 2. Education and training
  • 3. Clinical audit
  • 4. Clinical effectiveness
  • 5. Research and development
  • 6. Transparency
  • 7. Risk management
  • 8. Information management
  • 9. Managing and learning from complaints
  • 10. Seeking and responding to user views


Strong leadership both on an organisational and clinical level critically inclusive of a senior clinician, so that quality issues can be regularly discussed at board level

Education and training

Continuous professional development is a requirement for all healthcare professionals and critically is a requirement for all nurses through revalidation, in the United Kingdom.

Clinical audit

The ongoing review of clinical practice against agreed clinical standards 

Clinical effectiveness

A measure to what extent a particular clinical intervention works

Research and development

Clinical practice should be informed by research and developed and changed in accordance with evidence from research


Transparency and a commitment to openness is an essential part of quality assurance. Poor performance thrives in environments that are not open to public and professional scrutiny.

Risk management

Risk management can be divided into three areas;

  1. Risk to patients
  2. Risk to professionals
  3. Risk to the organisation

Information management

Compliance with data protection ensures the safety of patient records, appropriate management and use of information.

Managing and learning from complaints

It is important that learning from complaints is shared and timely action and improvements are acted on. Senior managers should take an active interest in complaints and review information gathered, analysis of outcomes will offer the opportunity to inform the improvement of quality services.

Seeking and responding to user views, including patient experiences

To ensure a truly responsive service all stakeholders must be invited to offer their views and give feedback on the services they receive and the environment and the manner in which the services are delivered.

Key care quality strategies in the UK

The United Kingdom’s regulatory and guidance bodies in health and social care provide detailed insight into key care quality strategies .These bodies include:

NHS England

Care Quality Commission (CQC)

National Institute for Health and Care Excellence Quality Standards (NICE),

The Department of Health (D o H)

Department of health, Social services and Public Safety (DHSSPS)

Healthcare Improvement Scotland

Scottish Government National Clinical Strategy for Scotland

Welsh Government.  Achieving excellence. The quality delivery plan for the NHS Wales

Welsh Government Together for health

Key messages include:

Development of new healthcare models to suit local needs, including multi-speciality community providers and primary and acute care systemsRights for patients, public and professionals and the responsibilities that the public, patients and professionals owe to one another
Remove wasteful practices and processesProtect and improve quality through the promotion of values including; empowerment, involvement, respect, partnership, learning, community, continuity, equity and equality
Emphasizing the role of digital healthcare in contributing to the redesign  of better health servicesReshaping services to make best use of resources ensuring safe, resilient and sustainability into the future
Redesign of regulatory services to focus a spotlight on quality and safety of careSetting out the quality standards people should expect from health and social care
Drive measureable quality improvements Support the delivery of person- centred care, safe and effective care
Reduce harm, variation of services and wasteProvide effective, timely and quality services

A basic over view of clinical governance and an understanding of strategic quality strategy should inform all healthcare professionals’ clinical practice. The clinical governance system is intrinsically linked with continuous quality improvement and ‘safeguards high standards of care by creating an environment in which excellence in clinical care will flourish’ (RCN).

Author: Sarah Mancini RN, BSc (hons) PGC. Director of Care and Quality – Revitalise
President of Nursing Matters Editorial Board