Quality 'built in' to everything we do

Clinical Governance & Training

The usual and classical quoted definition of clinical governance used in the UK is the one below given by Scally and Donaldson in 1998: 'Clinical governance is a system through which... organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish'.

The World Health Organisation has divided quality into four aspects:

  • Professional performance (technical quality)
  • Resource use (efficiency)
  • Risk management (the risk of injury or illness associated with the service provided)
  • Patient's satisfaction with the service provided.

Implementing clinical governance requires the transformation of culture, of ways of working, of attitudes and of systems. It must become a way of working and a way of thinking. Clinical governance is about changing the way people work, demonstrating that leadership, teamwork and communication is as important to high-quality care as risk management and clinical effectiveness.

Clinical governance requires changes at three levels: by individual healthcare professionals, by teams and by organisations.

  • Individual healthcare professionals need to embrace change – adopting reflective practice, which places patients at the centre of their thinking.
  • Teams need to become true multi-disciplinary groups, where understanding about roles, about sharing information and knowledge and about support for each other becomes part of everyday practice.
  • Organisations need to put in place systems and local arrangements to support such teams and assure the quality of care provided. Commitment and leadership from the senior management team throughout organisations is clearly crucial.

Successes should flow from interventions that are supported by active leadership. Ensuring that the lessons from clinical governance project work become part of the mainstream business of organisations is an essential task.

In order to prove that we have a successful clinical governance system we need to be able to provide evidence that we are assessing performance and responding to the assessments and taking steps to identify and resolve any areas where we see performance failing to meet acceptable standards.

Currently we have an indication of the effectiveness of our clinical quality from the following practices:

  • We have peer reviews of the medical reports produced; as reports signed by any of the medical team who will be proof reading reports written by colleagues.
  • We run external reviews, whereby customers are asked to assess medical reports against certain criteria regarding how useful they feel the report was in informing managers about the case.
  • We complete quality audits of the reports received within Health Management from doctors conducting independent medical assessments.
  • The Director of Clinical Governance audits the occupational health provision provided to organisations where we have an on site service on an annual basis.
  • A written complaints management process is also in place and any complaints about medical reports or the medical management of cases are referred to the medical director for investigation.
  • Health Management also has a 360 degree appraisal system in place for all the physicians.
  • Our OHAs have annual development reviews and checklists conducted.
  • We have developed an integrated governance system to establish effective clinical governance of the OHAs who are employed by Health Management but who operate within client's business locations.