The key to person-centred clinical excellence

Clinical governance is a relatively new concept that originated out of the NHS late last century in response to a number of significant and avoidable clinical events. It was originally defined by Gabriel Scully and Liam Donaldson in 1998 as: “ … a system through which healthcare organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care, creating an environment in which excellence in clinical care will flourish.”¹

For many decades, health agencies around the world have grappled with how to raise the quality of healthcare in an environment not at all conducive to doing so. Managers desperate to instil change have been stymied by a lack of direction, lack of adequate care data, and limited or inappropriate resources. This has been combined with the duplication or complete absence of appropriate service provision between primary and secondary care and geographical and service patch protection which prevents adequate health data being shared between agencies. This overwhelming burden of bureaucracy has meant the health consumer is constantly at risk of not receiving the level of care they need or deserve, particularly when accessing care across different thresholds. Faced with the ongoing requirement to meet fiscal and operational targets, managers must often make compromises that are at the expense of providing personcentred care. 

Prior to the widely accepted and adapted concept of clinical governance, healthcare agencies sought to plug their quality gaps through quality assurance programs that were not always mandated or underpinned by appropriate leadership nor effectively joined up or communicated adequately to care staff to effectively inform change. Hence, a myriad of different definitions and frameworks have evolved to understand and define clinical governance as it best relates to different healthcare environments. However, in the care home environment, at its essence it can be easily described as an opportunity for care staff and managers to constantly measure the pulse of the clinical health of their business; to plan effectively, to intervene quickly and early to improve resident safety, and to ensure that learnings are taken on board by individuals, the teams responsible, and embedded into the organisational culture at large.