Emerald Group Publishing Limited
Copyright © 2011, Emerald Group Publishing Limited
Article Type: Editorial From: Clinical Governance: An International Journal, Volume 16, Issue 3
There has been much debate about the use of term “governance” in clinical governance since its introduction in 1997. In the atmosphere surrounding the post-Shipman/Bristol/Alder Hey NHS, there is little doubt that its overtone of regulating independent professional autonomy was seen as a priority with our political leaders. There is little doubt that activity under the clinical governance banner has expanded to produce a diverse portfolio, and CGIJ has adapted to cover this diversity, as may be seen in this issue.
That sense of governance as overbearing regulation is seen clearly in the article entitled “Is the NHS, as an employer, overburdened with regulations, relating to its obligations to employees? Critical evaluation by an NHS employee” (George and Joseph). The issues raised in this article are about to become much more complex in the new marketplace envisaged by current health reforms, and are already at the heart of many discussions about spinning out current NHS enterprises as social enterprises.
A more enlightened view of governance places an emphasis on improvement and proactive interventions to prevent adverse events. At the heart of this proactive agenda is effective risk management. Nowhere is this more clearly seen than in mental health, which retains a stigma associated with adverse events, greater than almost any physical disease. The task of “Clinical risk assessment and management of service users” is dealt with by Bowers.
Clinical governance is a UK term, but CGIJ has sought to argue that the knowledge base is international, as are the issues and problems faced. With this in mind, Alhatmi presents an international case study of “Safety as a hospital organizational priority”. This article features work first described at the 2nd Canadian Quality Congress, and we hope to feature more work from this conference later in the year.
With my discipline as a health informatician, you will not be surprised that I regard information as the core of good clinical practice and governance. The final two papers, “Onsite handover of clinical care: implementing modified CHAPS”, by Basu, Arora and Fernandes and “Challenge of introducing evidence based medicine into clinical practice: an example of local initiatives in paediatrics” by Ogundele, highlight both the key role of information, and the problems associated with implementing innovations to improve information handling. Information handling remains the dimension of clinical governance most often highlighted by the Care Quality Commission in the UK as the weakest aspect of clinical governance in many care organisations.
With this in mind, my co-editor Nick Harrop will present a special issue in CGIJ Vol. 16 No. 4 which focuses on the role of information in clinical governance, and these papers offer a foretaste of what is to come.