Clinical Governance Essay

After the serious shortcomings within the Mid-Staffordshire NHS Trust came to light, The Francis Report (Francis, 2013) investigated how the conditions of inexcusable care could prevail within the trust. The Francis Report proposed several extensive changes that could improve the National Health Service (NHS). Garner (2014) informs that these changes include that leaders need to be effective and accountable, staff should be empowered to work in partnership, each trust should aim to improve innovation and quality, whilst putting the patient first. The Department of Health (DH) reflected on the findings and in response to The Francis

It also proposed new systems to enhance patient care, an emphasis upon health and wellbeing rather than illness and the increased devolution of decision making to local organisations. The need for more partnerships and joint working arrangements between Primary Care Trust’s, Local Authorities, independent and voluntary sector organisations, was also emphasised. A new performance framework was also implemented in April of 2005, Standards for Better Health (Department of Health, 2004) which sets out the level of quality all organisations providing NHS care are expected to meet (core standards) or aspire to (development standards) within UK healthcare. The standards to which the document refers are organised within seven domains ranging from safety and governance, to patient focus and public health and are designed to cover the full range and spectrum of healthcare as enshrined in the Health and Social Care (Community Health and Standards) Act 2003. National Service Frameworks and National Institute for Health and Clinical Excellence guidance are integral to this standards based system, whilst The Healthcare Commission has an ongoing and major function to play in the assessment and review of all healthcare organisations.

Provides comprehensive safe, quality practice to achieve agreed goals and outcomes that are responsive to the nursing needs of people

Every health professional has a legal obligation to patients. Nurses as part of the health care team share an important role in the quality and safe delivery of patient care. They have the major responsibility for the development, implementation and continuous practice of policies and procedures of an organisation. It is therefore essential that every organization offer unwavering encouragement and resources to support their staff to perform their duty of care in every patient. On the other hand, high incidences of risk in the health care settings have created great concerns for healthcare organizations. Not only they have effects on patients, but also they project threat to the socioeconomic status. For this reason, it is expected that all health care professionals will engage with all elements of risk management to ensure quality and safe patient delivery. This paper will critically discuss three (3) episodes of care from the case study Health Care Complaints Commission [HCCC] v Jarrett [2013] Nursing and Midwifery Professional Standards Committee of New South Wales [NSWNMPSC] 3 in relation to Registered Nurse’s [RN] role as a leader in the health care team, application of clinical risk management [CRM] in health care domains, accountability in relation to clinical governance [CG], quality improvement and change management practices and the importance of continuing professional development in preparation for transition to the role of RN.

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

In this essay I have endeavoured to show that quality, safe and effective healthcare practice is based o

The Care Quality Commission makes sure that hospitals, care homes, dental and GP surgeries, and all other care services in England provide people with safe, effective, compassionate and high quality care, and they encourage these services to make improvements.

Furthermore, staff ought to treat patients as co-producers of health and not passive recipient of care. Clinical governance (CG) is a notable driver of continuous improvement in the health sector. According to Department of Health (DoH) (1997) CG lays emphasises on excellence in clinical care. The NHS in 2013 established the improvement quality (IQ) which sought to support achievements of health outcomes in England. The Francis report (2010) highlighted various failures in quality of care at the Mid Staffordshire NHS Foundation Trust. Jennings (2008) argue for transforming healthcare by rapidly increasing and broadening world-class leadership with innovative ways of working and technology. The NHS leadership framework (2011) advocates for staff potentials to contribute effectively in service improvement regardless of their roles and disciplines. This permits a workforce that develops a culture of continuous service

The Health and Social Care Act 2012 came into force with crucial principles including new structures and arrangements in health care services to safeguard and strengthen the future of NHS and maintain the modernisation plan. In this Act, many new changes has been made to a number of existing Acts, National Health Services Act (NHS 2006), in order to enable health care system to tackle the existing challenges and also avoid any potential crisis in future. It has also introduced the proper allocation of NHS fund and budget, and improved the integrated care between NHS and social care services to promote patients’ choice in terms of delivering quality care.

The object of this essay is to discuss the role of the Assistant Practitioner. How it has emerged; how it fits into the structure and skill mix of the NHS workforce and the effect it has had on that structure. It will also outline the principles of accountability and statutory regulations that govern the day to day practice of the role.

The National Health Service (NHS) was planned as a three-tier structure. With the Minister of Health at the top and below were the three tiers designed to interact with each other to suit the needs of the patient. These tiers were voluntary and municipal hospitals supervised by Regional hospital boards, family doctors, dentists, opticians and pharmacists who were self-employed professionals contracted to the NHS to provide services so that patients did not pay directly and local health authorities like community clinics that provided services such as immunisations, maternity care and school medical services controlled by a local authority Medical Health. The NHS in England is undergoing some big changes, most of which took effect on April 1 2013. This included the abolition of primary care trusts (PCTs) and strategic health authorities (SHAs), and the introduction of clinical commissioning groups (CCGs) and Health watch England.

“Running a health care organization is a team sport. It is very important that all members of the team-whether on the medical staff, in management or on the board-understand the role of governance and what constitutes effective governance” (Arnwine, 2002). Running a hospital is a difficult task. Several factors need to be seriously thought of and considered in every decision and undertaking. Unfortunately, all the three important factors in governing a hospital is not always in harmony. As likened to a team sport, if the three major components are not working with each other as a team, there will be tension and a great divide will be experienced. And often times, the patients will be in the middle and will be greatly impacted. This writer believes that there are several factors that contribute to the tension that usually exists among the medical staff, the board and administration. One factor is the disconnect, where each entity is not seeing each other eye to eye and their visions may be different from each other. Another factor may be the lack of communication in order to bridge the gap and to build a respectful and a relationship wherein there is trust for each end every member of the group. Often times, the medical staff is concerned with ensuring that patients are cared for in a manner that their practice is protected as well as the patients are getting the appropriate care. On the other hand, the board of trustees may be focused in ensuring that that

Shared governance grew in popularity because of nurses’ dissatisfaction with hospitals administration but waned in interest in the 90’s. Shared governance has suffered from a variety of names and interpretations and although these definitions differ in their depth, common words like autonomy and empowerment and collaboration always arise.

In line with the majority of other developed countries, the United Kingdom (UK) has offered its citizens a universal health care system that is free at the point of service. Funded primarily by taxation, the system is popular and efficient. However, along with most other health care systems around the world, it faces a series of challenges if it is to maintain viability, in the twenty-first century. These issues include; long waiting times, an aging population, funding challenges and the increasing cost of technology.

A clinical audit is a quality improvement process which aims to improve care through a systematic review of practice against evidenced based criteria, followed by the implementation of change (Healthcare Quality Improvement Partnership, 2011). There are many different audit cycles to choose from which could be confusing for practitioners (Dixon & Pearce, 2011). The audit cycle pictured below (figure1) was selected as a bases for this project because it is simple to use and emphasises the importance of maintaining improvements.