Clinical Governance

1
Clinical Governance

• VTS Scheme Presentation
• Feb 2003
• Matt Walsh

2
Who am I?

• GP
• Trainer
• Bradford VTS graduate
• S W Bradford PCT Director for Quality

3
Aims for the session

• To assess current levels of understanding of
  clinical governance
• To understand the history.
• To improve understanding of the principles behind
  the concept of clinical governance
• To understand some of the tools.
• To test some of the tools in a practical setting.

4
What does it mean to you?

• What words do you think of?
• How does it make you feel?
• What experience have you of clinical
  governance?
• Can you describe what it is?

5
Clinical Governance - a Definition
A framework through which NHS organisations are
accountable for continually improving the
quality of their services and safeguarding high
standards of care by creating an environment in
which excellence in clinical care will flourish
Donaldson and Scally
6
Clinical Governance - a Definition
A framework through which NHS organisations are
accountable for continually improving the
quality of their services and safeguarding high
standards of care by creating an environment in
which excellence in clinical care will flourish
Donaldson and Scally
7
(No Transcript)
8
Organisation

• A group of persons organized for a particular
  purpose an association a benevolent
  organization.
• A structure through which individuals cooperate
  systematically to conduct business.
• The administrative personnel of such a structure.
  

9
Accountable

• Liable to being called to account answerable.

10
Environment

• The circumstances or conditions that surround
  one surroundings.
• The totality of circumstances surrounding an
  organism or group of organisms, especially
• The combination of external physical conditions
  that affect and influence the growth,
  development, and survival of organisms
• The complex of social and cultural conditions
  affecting the nature of an individual or
  community.

11
In other words

• The practice (and therefore the practitioner)
  will be called to account and asked to
  demonstrate on a regular basis that the quality
  of care for its patients is continually
  improving..

12
In other words

• and to do this it will need to influence the
  complex of social and cultural conditions
  affecting the nature of the individuals and teams
  working with and for the practice community.

13
Quality
Define what it is that we are producing?
Design and implement changes to production.
Produce it
Compare what we have produced with our standard.
14
What is the role of the GP in this?

• Duties of a doctor (GMC).
• Good Medical Practice (GMC).
• Good Medical Practice for GPs (RCGP)
• Supporting Doctors, protecting patients (DOH)

15
The Duties of a Doctor.(1)

• make the care of your patient your first concern
  
• treat every patient politely and considerately
• respect patients' dignity and privacy
• listen to patients and respect their views
• give patients information in a way they can
  understand

16
The Duties of a Doctor.(2)

• respect the rights of patients to be fully
  involved in decisions about their care
• keep your professional knowledge and skills up to
  date
• recognise the limits of your professional
  competence
• be honest and trustworthy
• respect and protect confidential information

17
The Duties of a Doctor.(3)

• make sure that your personal beliefs do not
  prejudice your patients' care
• act quickly to protect patients from risk if you
  have good reason to believe that you or a
  colleague may not be fit to practise
• avoid abusing your position as a doctor and
• work with colleagues in the ways that best serve
  patients' interests.

18
SWOT analysis for self

• Think about why you get up for work in the
  morning.

19
Define a quality framework for general practice.

• Clinical
• User
• Infrastructure
• Staff

20
Rules

• Safe environment
• Well chaired
• Relevant information provided beforehand
• About I not about you,

21
Potential outcomes

• Celebrate
• No further action
• More detailed audit
• Change to strategy or training plan

22
Significant event audit

• where individual cases in which there has been a
  significant occurrence, not necessarily involving
  an undesirable outcome for the patient are
  analysed in a systematic way to ascertain what
  can be learned about the overall quality of care
  and to indicate changes which might lead to
  improvement

23
Scenarios and feedback
24
Clinical governance

• Nothing new
• Opportunities and threats
• Can support us
• Brings some resources with it
• Might make us feel better