Primary care groups: Improving the quality of care through clinical governance

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Abstract
This is the third in a series of five articles The UK government has set a challenging agenda for monitoring and improving the quality of health care. It is based on a series of national standards and guidelines, a strategy for quality improvement termed “clinical governance,” and a framework for monitoring the quality of care in and performance of NHS organisations (box). Clinical governance is “a framework through which NHS organisations are accountable for continually improving the quality of their services, safeguarding high standards by creating an environment in which excellence in clinical care will flourish.”1 To be successful this strategy requires effective leadership by clinicians who have responsibility for improving quality; it must engage the doctors and nurses who provide care on a daily basis; and it must have commitment and support from managers within the NHS. #### Summary points Primary care groups and trusts are responsible for implementing clinical governance, including monitoring and improving the quality of care In their first two years they have concentrated on educating and supporting health professionals and encouraging shared learning Information about the quality of care provided in general practice is being shared between practices and with the public, often in a form that permits practices to be identified Many groups and trusts are offering incentives to practices to promote improvements in the quality of care Sanctions and disciplinary action are rarely used when dealing with poor performance Limited resources and the pace of change are potential obstacles to future success in improving the quality of care #### Goals of quality improvement strategies in the NHS National service frameworks, National Institute for Clinical Excellence —set standards, develop guidelines Clinical governance —deliver care, improve quality National performance framework, annual appraisal of doctors, Commission for Health Improvement, national surveys of patients —monitor quality and performance Primary care groups and trusts are responsible for implementing clinical …

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