Clinical governance in primary care

Summary

Following serious concerns about clinical and organisational failures in the NHS during the 1990s (such as Alder Hey, the Bristol Royal Infirmary and Shipman), the Government identified the need for a more systematic approach to improving quality and safety in healthcare.

This Report ‘Clinical Governance in Primary Care’ (HC 302) examines the introduction of the clinical governance framework in the NHS.

The Department of Health introduced clinical governance, a framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care.

Primary Care Trusts (PCTs) are responsible for providing primary care services and commissioning services on behalf of their local health economy.

This Report examines:

The Department’s progress in implementing clinical governance in primary care
The lessons learned
The risks that will need to be managed, if quality and safety are to be embedded in the new PCTs.

The Committee finds that clinical governance is not as well established in primary care as in secondary care, largely because of the complexity of PCTs role in both commissioning and providing care; and the independence of contractors delivering healthcare, particularly General Practitioners (GPs).

The Report states that primary care has also been slower in adopting a structured approach to quality and safety, evident in the lack of compliance with national systems reporting of clinical incidents. There is a lack of clarity between PCTs and their contractors as regards accountability for ensuring quality and safety, and scope for greater involvement of patients and the public in ensuring that primary care services are safe and of high quality.

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Law-Making Explained

This is a House of Commons Paper (HC 302 2006-07): it is a Report from the House of Commons Committee of Public Accounts.

Find out more about House of Commons Papers.

How does it affect me?

If you work in the health sector or are a patient of the NHS, this affects you.

Chairman of the Committee, Edward Leigh MP, said:
“Clinical governance must result in real improvements to the quality of services to patients and to levels of patient safety. Patients want to be listened to by PCTs when the latter are making decisions on commissioning services. And PCTs need to show patients what effect their views have had.”