Clinical Governance

Practice Development for Clinical Governance

View the Clinical and Social Care Governance Guide for General Medical Practice

The development of clinical and social care governance in the HPSS is a key aspect of the Department’s quality agenda arising out of the public consultation on Best Practice-Best Care. In line with that agenda, a significant programme of work is underway in the HPSS to improve quality and ensure safety. A statutory duty of quality has been imposed on HPSS organisations and clinical and social care governance arrangements are being developed. Clinical Governance is a way for organisations and individuals to ensure the delivery of high quality healthcare. It is designed to help organisations and individuals continuously monitor, maintain and improve standards of care. An efficient organisation has a system for improving quality, Clinical Governance is the system in the NHS. It focuses on:

  1. Continuing Professional Development.
  2. Evidence based practice and quality improvement activities.
  3. Identifying and managing risks.

The majority of practices are already doing many of the elements of Clinical Governance and just need to document what happens to formalise the activities. However, it is important to remember that this is a long-term process, which involves step-wise improvement. It doesn’t need to be done all at once.

Each practice has appointed a Clinical Governance Lead, whose role is to:

  • Act as practice link with the health board.
  • Work out a practice plan for Clinical Governance in collaboration with practice team, with the help of the health board if desired.
  • Ensure the plan is implemented.
  • Keep up-to-date with Clinical Governance and quality issues.

The plan should include regular progress reports to team meetings, and any training implications for team members.

The Northern Ireland Medical and Dental Training Agency (NIMDTA) has developed this handbook to provide General Practitioners and practice teams with a formative tool to facilitate a proactive approach to the demonstration of clinical and social care governance at practice level. This handbook will facilitate the recording of activity and document how these activities have changed and improved practice. The main components of the handbook are:

  • Continuing Professional Development e.g. Demonstration of practice based activities.
  • Evidence based practice e.g. evidence of use of guidelines and standards.
  • Risk Management e.g. repeat prescriptions, health & safety procedures.
  • Significant event audits e.g. organisational/clinical events which impacted on patient care.
  • Audit e.g. demonstration of participation in and any changes made to practice as a result of audit activities.
  • User/Patient involvement e.g. evidence of patient participation (satisfaction surveys, participation in practice development).

The practice handbook will facilitate the gathering of evidence in the above categories and can be signed off by the Clinical and Social Care Governance Practice Lead and also by each GP, as a record of their active participation in clinical and social governance activities at practice level. This evidence will not only provide practice based evidence for the annual contractual review but also could provide significant evidence for each GP of his/her role in improving the quality of patient care within his/her own practice development.

DO NOT try to read this folder from cover to cover. Much of the material is intended as reference to be used if you decide to embark on a new course of action. It is not essential that you do more work on quality but it is intended that you collate and cross reference ongoing practice activity. Should you decide to embark on new practice quality activity then we hope you will find the reference material (mostly reproduced with kind permission from Ashleigh and Wigan Primary Care Quality Group and the BMA) useful. The aims of this portfolio are:

  • to facilitate GPs and their practice staff to draw together outputs from those quality improvement measures which are taking place in the practice
  • to highlight to the practice some other quality control measures which they might wish to consider implementing
  • to provide a statement by all doctors that they are participating in quality assurance mechanisms within the practice
  • to provide reference material around elements of Clinical Governance
  • to facilitate the practice in identifying priorities for improvement in the subsequent year.

The Clinical Governance lead should ensure that the outputs of practice quality initiatives such as audits and significant event analyses are drawn together within the portfolio and stored in the relevant section of the folder. This will make it easier for you to identify priorities for action for next year and, should you agree, then it will be a resource to demonstrate Clinical Governance activities to your board. We wish to thank the Ashleigh, Leigh and Wigan Primary Care Quality Group for permission to use sections of their reference material.

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