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Clinical governance
Prescribing how NHS trusts “do” quality: a recipe for committees but little action?
  1. P M Whitty
  1. Correspondence to:
 Dr P M Whitty
 Centre for Health Services Research, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK;

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The jury is still out as to whether the current clinical governance model is the best way to improve quality

Clinical governance, together with a number of national bodies to support and monitor it, was established in the NHS in 1997.1 Seven years on, it seems a good time to reflect on how effective this national quality assurance/improvement strategy has been, particularly in the light of subtle changes in the UK government’s attitude to quality. The recent publication of a new standards framework,2 the replacement of the Commission for Health Improvement (CHI) with the Healthcare Commission from April 2004, and insistence that trusts will have greater local autonomy2 all suggest a change in the wind—although the direction of the change is not quite clear.

In the initial guidance on the duty of NHS trusts to implement clinical governance,3,4 the government set out the mandatory components of clinical governance (variously …

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