Clinical Governance

Written by our Clinical Governance lead Dr. Rana Fard.

Clinical Governance is essentially a way to improve the standard of care across the board within healthcare and to minimise the risk to patients. 


Scally and Donaldson (1998) define it as:


“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.”


The NHS Clinical Governance Toolkit defines clinical governance as:


“Clinical governance has been defined as a system through which healthcare 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. 

Effective clinical governance ensures that risks are mitigated, adverse events are rapidly detected and investigated openly, and lessons are learned. “

You can find the link to the NHS Clinical Governance Toolkit below:


There are three main strands to clinical governance:

  1. Quality improvement work

  2. Fostering a culture of learning

  3. National and local quality improvement systems and structures

Ultimately this helps to create healthcare system which has the following characteristics of being:

  1. Safe

  2. Effective

  3. Patient Centred

  4. Timely 

  5. Efficient

  6. Equitable


The Royal College of Nursing highlights five key principles of Clinical Governance:

  1. “Patient focus - how services are based on patient needs 

  2. Information focus - how information is used 

  3. Quality improvement - how standards are reviewed and attained 

  4. Staff focus- how staff are developed 

  5. Leadership - how improvement efforts are planned.”


You can find their full guidance by clicking below:


Good clinical governance is about continual improvement of patient care and fostering an attitude of critical engagement and reflection. Good clinical governance has the foundation of seven pillars:

  1. Audit 

  2. Clinical Effectiveness

  3. Risk management 

  4. Patient/ Service user and public involvement

  5. Education and training 

  6. Information management

  7. Staff management 


These must be continually assessed in clinical practice and any areas of improvement which are identified must be acted upon. In doing so, the overall standard of care for patients increase whilst the risk in clinical practice will decrease.


For a great summary of the seven pillars check out the video below:


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Record Keeping