For individual practitioners: what is clinical governance and why is it important?

What is clinical governance?

Fundamentally, clinical governance is about taking measures to deliver the best care we possibly can, for each individual patient (remembering no two patients will ever be identical).?Therefore it is not just a concept for hospitals, but applies equally to private practice.

Clinical governance involves thinking about how we do things, for the ‘why’.?Therefore clinical governance covers everything from authentic patient and staff engagement (including non-clinical staff), clear communication and informed consent, robust record keeping, psychological and cultural safety, pro-active risk identification and management, effective incident response and open disclosure, ethical and sensitive professional conduct, compassionate and practical leadership (at all levels), and continuous improvement. These issues are just as relevant in everyday practice for private practitioners, as they are within larger organisations - because they all impact the patient experience.

The focus in clinical governance must always be the patient - and the more we can improve on each dimension in clinical governance, the more we can improve on the outcome for the patient as an individual.

Why is it important?

Understanding clinical governance gives us a mental framework to consider how we can do things better for our patients.?It's otherwise easy to forget the 'art' of medicine, because we are naturally so focussed on its science, through how/what we are taught at university - after all, the 'art' comes with real-life experience. By identifying the range of factors that impact patient care in practice - ie. those elements of clinical governance (such as those listed above) - we remind ourselves to address them.?For example, as medical practitioners we should be constantly learning, and as such we must always consider how to continuously improve for the benefit of our patients.

Clinical governance involves working together with our patients towards the outcomes that they desire - understanding what ‘quality’ means for them, and managing their expectations through open, honest, transparent and two-way communication.

Of course the happier our patients, the less likely they are to make a complaint - so good clinical governance will reduce our medico-legal risk as a happy by-product of good care.