Reports > The Fifth Report > CHAPTER TWELVE - Clinical Governance >
Structures and Systems
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12.6 |
At the Inquiry’s seminars, Professor Aidan Halligan, Deputy Chief Medical Officer for England and Director of Clinical Governance for the NHS, emphasised that the essence of clinical governance was ‘a system of accountability for care’. Delivery of clinical governance was, he said, dependent on ‘architectural artifices’: structures, processes, mechanisms and clear accountability arrangements. |
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12.7 |
It is, of course, evident that good governance - of whatever organisation - requires sound structures and well-designed systems. If there are no effective lines of management accountability, for example, no one will take responsibility when things go wrong. If no proper complaints system is in place, complaints will go unrecorded and potentially valuable information about poor practice or outcomes will be lost. If an organisation has no whistleblowing policy, staff may be deterred from reporting colleagues who may be guilty of dishonesty or incompetence. An absence of a system of financial checks may result in widespread fraud. |
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12.8 |
However, sound structures and systems are not, on their own, enough to secure good governance. A complaints system is of no value unless those who are intended to use it (customers, clients, patients, etc.) know of its existence and unless staff within the organisation are trained to operate it effectively. A whistleblowing policy will not be used unless staff are made aware of it and are confident that, if they voice their concerns, those concerns will be taken seriously and the organisation will deal with them fairly. It is essential to ensure that clinical governance extends to every layer of a NHS organisation so that all members of the organisation are putting into practice the systems intended to promote quality. |
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12.9 |
In the context of primary care, this means extending the systems, not only to the level of PCT staff, individual GPs and other healthcare professionals, but also to members of staff of all general practices in the area. Under the new General Medical Services (GMS) Contract, contracting practices are required to have in place an effective system of clinical governance. |
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Introduction
