Clinical Governance and Risk Managment

One of the aspects of UK healthcare that is supposed to help us provide good quality care for our patients in clinical governance. All NHS organisations will have clinical governance committees and these help the trusts manage risk.

I have tried to compile details of what clinical governance is, and how it can be used to help nurses improve the care we provide to our patients.


What Does It All Mean

Clinical governance is a system for improving clinical practice. It was first described in a White paper as a system to make sure that clinical standards are met and that processes are in place to ensure continuous improvement, this is a statuary duty of NHS trusts.

Clinical Governance includes activities such as clinical audit, incident reporting, education, training, research and development and risk management and complaints.

Below are some links to excellent clinical governance websites, these help explain governance and what should be in place in NHS trusts.

• RCN Link
• CG Link
• DOH Link

Clinical Governance and Nursing

So how as nurses can we use clinical governance to improve the care we provide for our patients.

One of the things that nurses can do to help improve care is incident reporting, it is something that we are often reluctant to do as there is the feeling that we are telling tales or getting colleagues into trouble. There is also sometimes the feeling that reporting makes no difference. However, all incident reports will go to a central risk management department for analysis and to look for trends, if there are numerous reports about incidents linked to problems providing care then a investigation will be requested, this will be at times internal but sometimes as an external investigation. Without these incident reports the governance committee will be unaware of the problems that are being experienced on the wards and sometimes even your direct line managers may not be aware of the scale of the problem.

There are some government initiatives that have been designed to help nurses and other members of the multi-disciplinary team improve the service we provide to our patients.

Get involved in initiatives that have been designed to help us improve care for our patients such as:

Safer patient initiative - In trial trusts this has addressed key areas of patient safety such as better management of patients in intensive care, infection control, preventative antibiotics for surgery and medicines safety.

1000 Lives Campaign - Welsh version of SPI

Essence of care: benchmarks for the care environment - Looking at environments of and and how to improve them

Releasing Time to Care: The Productive Ward - The Productive Ward focuses on improving ward processes and environments to help nurses and therapists spend more time on patient care thereby improving safety and efficiency

Fundamentalsof Care - The welsh response to the essence of care, looking at basic care needs and what nurses should be trying to achieve.