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4. Progress so far
Professor Aidan Halligan
Implementation is supported by a national director of clinical governance for the NHS, Professor Aidan Halligan, and the work of the NHS Clinical Governance Support Team (CGST). The CGST was established in September 1999 and is part of the NHS Modernisation Agency. Due to changes in the Modernisation Agency the CGST's main programme, the Clinical Governance Development Programme, will not run beyond March 2005.
Professor Aidan Halligan is Deputy Chief Medical Officer and Director of Clinical Governance for the NHS
The CGST runs a range of innovative development programmes for multidisciplinary teams, individuals and NHS organisations, to enable them to deliver locally owned, effective clinical governance on the ground.
Over 1,600 teams have been through CGST programmes during the last five years, as its work has expanded to support frontline healthcare and NHS board teams as they implement clinical governance in their organisations. The CGST runs a Board Development Programme and a Team Resource Management and Patient Safety Programme. Other teams are dedicated to supporting 'zero star' trusts, primary care, and improving the patient experience so that patients and carers are at the centre of clinical governance.
The CGST also acts as a focus of expertise, advice and information on clinical governance, seeking to improve awareness and understanding among NHS organisations, healthcare professionals and patients.
Lessons learned from CGST activities, in particular good practice that other NHS professionals can adapt to local circumstances, are captured and then communicated across the wider health community through the team's website.
A range of online clinical governance resources for effective implementation is provided, drawn from the real experiences of frontline teams who have attended CGST programmes. These include:
- Three sets of 20 'lesson cards' each containing short and readily applicable hints to help implement clinical governance
- 'Eurekas!' which capture short, engaging stories of improvement for other NHS organisations to share and learn from. For example, a health check-up leaflet with children's input
- Performance Enhancement Stories (PENS) and more detailed case studies that demonstrate how teams have used their learning from clinical governance programmes to improve frontline services. For example 'Presenting the right image: Your baby on video'
- A CGST email bulletin, available from:
Reporting on progress
The work of the Clinical Governance Support Team in promoting safe, high-quality patient-centred care within the NHS has been endorsed by two reports:
The National Audit Office report of 2003, 'Achieving improvements through clinical governance: a progress report on implementation by NHS trusts', recognised the role of the CGST in supporting NHS organisations. It found that some 43% of NHS trusts had used CGST programmes and that they had generally found them useful. It also recorded a significant level of change resulting from involvement with the CGST, including increases in staff awareness and understanding, greater engagement with ideas and processes, and improved team working.
The Manchester Centre for Healthcare Management produced 'All change? Implementing clinical governance in NHS trusts' (2003) which reported on positive responses from NHS trusts about their engagement with the CGST's development programmes.
An evaluation of the NHS quality agenda was also published in 2003, called 'The Quest for Quality in the NHS: A mid-term evaluation of the 10-year quality agenda', produced by the Nuffield Trust. It reports on the Government's drive to introduce quality and progress into the NHS. Professor Sheila Leatherman states that the structures and organisational arrangements for clinical governance have been put in place in the NHS, and most importantly, that patient-centredness is becoming a reality.
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