Clinical governance in primary care: Participating in clinical governance

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Abstract
This is the fourth in a series of five articles Earlier papers in this series have highlighted the collective nature of clinical governance in primary care and the central role of primary care groups, trusts, and practices. But definitions of clinical governance have also emphasised the responsibilities of individuals, highlighting the importance of lifelong learning by all clinicians and creating a clear obligation actively to manage poor professional performance when it is identified.1-3 This article will concentrate on the implications of clinical governance for individuals working in primary care. All primary care practitioners will have to develop systems for clinical governance. This includes pharmacists, opticians, and dentists, for whom the relative isolation of their practices can make such work difficult.4 The main focus of this paper will be on clinical governance in general practice. The paper will explore the relation between clinical governance, continuing professional development, and revalidation. It will consider how an individual's learning and development can be linked to that of the practice as a whole. It will also consider the need to protect the public from unacceptable care and the need to manage poor performance. #### Summary points Clinical governance is intended to improve standards of care and at the same time to protect the public from unacceptable care The move from continuing medical education for doctors to continuing professional development for the whole primary care team presents new challenges for multidisciplinary learning and performance monitoring To deal with poor performance, clinical governance leaders will need skills to assess the nature of the problem, educational resources to deal with it, and managerial resources to facilitate the process Participation in the activities of clinical governance will be an essential feature of revalidation Clinical governance represents a new formulation of age-old activities. The Royal College of Nursing established a range …

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