An inspector calls

Abstract

Purpose

The purpose of this paper is to summarise key concepts within clinical governance by reference to literature, and to present the topic of statutory clinical governance inspections of hospitals.

Design/methodology/approach

Conceptual paper in form of extended editorial; rapid, non-systematic review of basic clinical governance literature from UK, Republic of Ireland and Australia.

Findings

The Mid-Staffordshire Hospitals report (Francis, 2013) is evidence that, more than 15 years after its inception, clinical governance in the UK has not yet fulfilled its mission. This report has stimulated the subjection of all NHS provider institutions to a statutory inspection regime. Two different yet complementary, authoritative perspectives on clinical governance are identified and discussed. Whilst the inspection regimes methodology is under review, the object of inspection is not. The object of inspection could usefully be broadened to bring the arms length planning and funding bodies associated with provision under closer scrutiny for their obligation to engage constructively and collaboratively with providers in difficulty.

Research limitations/implications

A more extensive, systematic study of international literature will provide a foundation for international comparison studies which will enable participants in clinical governance to learn from each other.

Practical implications

The information contained in this brief review will assist practices of governance inspection and local self-governance.

Originality/value

Other studies (e.g. Brennan and Flynn 2013) have garnered definitions of clinical governance from other health systems, which tend to emphasise accountability as the key concept. Inspired by Halligan (2006), the present contribution stresses leadership and empowerment alongside accountability (in the sense of enabling “every clinical team to put quality at the heart of their moment-to moment care of patients”. It implies that accountability to “create an environment in which excellence in clinical care will flourish” should lie not only with individual clinical departments and healthcare provider institutions but also with funding and planning bodies such as the Clinical Commissioning Groups, recently introduced in the UK. The latter are not subject to the same inspection regime as providers but could usefully be made more accountable to engage constructively and collaboratively with providers in difficulty (Colin-Thomé, 2013).

Citation

Harrop, N. and Gillies, A. (2014), "An inspector calls", Clinical Governance: An International Journal, Vol. 19 No. 3, pp. 186-190. https://doi.org/10.1108/CGIJ-08-2014-0025