Clinical Governance - Rachel McEnery
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Transcript Clinical Governance - Rachel McEnery
CLINICAL
GOVERNANCE
Dr Rachel McEnery GP trainer
Kilmeny Group Medical Practice
Aims and Objectives
To understand the role and significance of Clinical
Governance in General Practice
Highlight potential areas that may come up in your AKT
Inspire you to become Clinical Governance leads in your
future practice!
Agenda
Introduction
What is Clinical Governance?
Small group work looking at cases, SEAs or Audits
Discussion
Clinical Governance - Definition
‘a framework through which NHS organisations 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’
Scally and Donaldson 1998
Clinical Governance – History
1997: The New NHS – modern, dependable
1998: A First Class Service: Quality in the New NHS
GMC: Duties of a Doctor and Good Medical Practice
RCGP: Good Medical Practice for General Practitioners
2008: Lord Darzi High Quality Care For All – NHS next stage
review
Clinical Governance Structure
Individual
Practice
PCT
SHA
DoH
Independent regulators CQC and Monitor
National Quality Board
RCGP
GMC
7 Pillars of Clinical Governance
1. C……….. E……….. & R………..
2. A….
3. R… M………
4. E…….. & T……..
5. P…… & P….. I………
6. U…. I…….. & I.
7. S……. & S……. M………
Health organisations also need L………, T… W…, A………….
and a C…… of openness for Clinical Governance to be
effective.
7 Pillars of Clinical Governance
1. Clinical Effectiveness and Research
2. Audit
3. Risk Management
4. Education and Training
5. Patient and Public Involvement
6. Using Information and IT
7. Staffing and Staff Management
Health organisations also need Leadership, Team work,
Accountability and a Culture of openness for Clinical
Governance to be effective.
Clinical Governance key components video
Leadership
Establish direction or vision
Persuade people to share
the vision
Communication/listening
skills
Innovate
Responsibility, respect,
integrity, authority
Ability to inspire and motivate
Ability to interpret data
Good and fair judgement
High standards
Accountability
Answerability
Responsibility
Blameworthiness
Liability
Culture
No blame
Patient first
Safety
Desire for quality
improvement
Openness
Learning
Education and reflection
Supportive
Clinical Effectiveness and
Research
The Right person doing:
The Right thing (evidence
based practice)
In the Right way (skills and
competence)
At the Right time (providing
treatment or services when
the patient needs them)
In the Right place (location
of treatment/services)
With the Right result (clinical
effectiveness/maximising
health gain)
Audit
Aim of the audit process is
to ensure that clinical
practice is continuously
monitored and that
deficiencies in relation to
set standards of care are
remedied
At practice and national
levels
Education and Training
CPD
Appraisal and Revalidation
Patient and Public Involvement
Patient and public feedback to
improve services, for
development of services and
monitoring treatment outcomes
PALS
LINKs
Local feedback questionnaires
Patient participation groups
Patient satisfaction surveys local
and national
Suggestion boxes
Lay members on interview
panels, complaints hearings and
trust boards
Using Information and IT
Patient data is accurate and
up to date
Data protection
QOF
Staffing and Staff Management
Appropriate recruitment and
management of staff
Organising a programme of
education, training and
appraisal of all in the service
to motivate and develop staff
and encourage retention.
Systems to identify poor
performance
Implementation of strategies
to correct poor performance
Risk Management
2 stage process
1.
2.
Risk Assessment
Risk Management
Includes infection control
Reporting of incidents via SEA
Promote a blame free culture
www.nhstaps.org.uk
www.npsa.nhs.uk
www.nrls.npsa.nhs.uk
MaPSAF
Primary care trigger tool
Risk Management
Risk management video - Bodies series 1
Risk Management
What key elements of
Clinical Governance were
and were not demonstrated
here?
What should have
happened?
Small Group Work
Discussing Audits, SEA or cases.
Conclusions
Nothing new
Opportunities and threats
Can support us
Might make us feel better!