Clinical governance was first established in the UK in 1997 (1). The most widely accepted definition is “a system 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” (2). Since then, clinical governance principles have been incorporated into service development across the NHS, particularly in the secondary care. There are generally held to be seven pillars of clinical governance, namely, patient and public involvement, staffing and staff management, clinical effectiveness and research, using information and IT, education and training, risk management and audit.
Pearson et al (2017) suggested a clinical governance matrix framework that can be used to provide assurance of quality from an individual and team level up to multiple services and across organisations(3). It is based on the pillars of clinical governance and current CQC domains of quality. The matrix framework is designed to be flexible for bespoke use with agreed measures as well as being a comparable methodology to use across different pathways/teams (3).
Clinical governance dashboard tools can be transferable across disciplines, departments, trusts and organisations to assist with quality improvement (4). The principles and language are now very familiar and recognised by all professionals and departments working across the NHS. The NHS has been called upon to adopt a systematic approach to quality improvement (5).
Applying the NHS clinical governance framework to an Active Hospital project will ensure patient safety and quality of care is consistent. As the activities of the project effect patients across the trust, it is also important that there is a systematic approach to the overall team governance and also that there is a mechanism for feeding back governance issues into each pathway effected. This allows for a credible integration of a governance structure. All departments within NHS trusts will have existing governance processes with regular meetings and quality improvement activities.
Clinical champions from each of the Oxford Pilot pathways were invited to attend quarterly Active hospital Governance meetings and will then feedback to specific pathways when applicable.