PEPs - Clinical Quality and Evidence

Module 5 - Clinical Governance


What does governance mean?

Governance refers to the act of governing. Governance relates to consistent management, cohesive policies, guidance, processes and decision-rights for a defined area of responsibility.

Failure of governance

The concept and importance of governance can be best understood when there is a failure of governance and the overall standards one would expect to be in place are not maintained. Failures of governance often arise from a failure of the appropriate people to take responsibility and/or the lines of accountability becoming blurred so that staff act autonomously when inappropriate to do so. Recent societal problems as diverse as the 2008 banking crisis, the scandal of expenses for Members of Parliament and the exposure of newspapers allowing reporters to use underhand tactics² all relate to failure of governance.

In recent years there have been several high profile health scandals caused by a failure of governance in one form or another, including the Winterbourne View care home scandal ¹ (see the Department of Health ² report for details) and the public inquiry into Mid Staffordshire NHS Foundation Trust that produced the Francis Report ³.

  1. Winterbourne View: calls for changes to adult care (BBC News Website - Video Report)
  2. Winterbourne View Hospital: Department of Health review and response
  3. Mid Staffordshire NHS Foundation Trust Public Inquiry