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11. Clinical Governance

11.1 Clinical governance was defined in the 1998 consultation document ‘A First Class Service: Quality in the New NHS’ 22 as:

‘a framework 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.’

11.2 The ethos of clinical governance has been embedded throughout this document. However, the key components and themes that promote good clinical governance are stated here for clarity. These components and themes are aimed at sizeable healthcare organisations but are nevertheless relevant themes that every independent practitioner and small independent practice will need to consider to ensure they have relevant policies and procedures in place.

  • Patient, public and carer involvement; to include analysis of patient /professional involvement and interaction, and strategy, planning and delivery of care.
  • Strategic capacity and capability; including planning, communication and governance arrangements and cultural behaviour aspects.
  • Risk management; incident reporting, infection control, prevention and control of risk.
  • Staff management and performance; recruitment, workforce planning and appraisals.
  • Education, training and continuing professional development; including professional re-validation, management development, confidentiality and data protection.
  • Clinical effectiveness; clinical audit management, planning and monitoring, learning through research and audit.
  • Information management; patient records and other record keeping.
  • Communication; patient and public, external partners, internal, board and organisation-wide.
  • Leadership throughout the organisation; including Board, Chair and non-executive directors, chief executive and executive directors, managers and clinicians.
  • Team working within the service; working with senior managers, clinical and multi-disciplinary teams and across organisations. Independent practitioners have a professional responsibility to interact with other health care professionals and to seek feedback. Responsibilities within a skills mix environment are described in the SCoR ‘Team Working in Clinical Imaging’ document published jointly with the Royal College of Radiologists in 2012.23

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