The attractive box set contains the book and companion CDROM. The two create an excellent package and justify the price. They are the product of a partnership between the NHS Executive's Clinical Governance Support Team (CGST), led by Professor Aidan Halligan, and HSJ. The book describes the background to clinical governance in the NHS and how progress can be achieved. The CD provides valuable material, including relevant HSJ articles, web links and details from the CGST's highly acclaimed five-day clinical governance development programme. The book and CD provide a practical, broadly based primer for managers on how to improve patient care.
Those who have not attended the CGST's development programme will want to apply after studying this package. The programme helps multidisciplinary staff to realise that they have the ability to improve patient care given the right organisational environment.
The CD's PowerPoint slides describe how improvement in patient care must be pursued with constancy of purpose both 'bottom up' and 'top down'. One without the other will be unrewarding for patients and staff.
The delight of this publication is the practicality of what is described. Too often, clinical governance books are inaccessible to the people on whom success depends. This one gives clear, straightforward descriptions and tells how to make improvements.
The well presented text incorporates many NHS examples punctuated with questions and cross-references to the CD. These are encouraging and give the reader confidence in the possibility of improvement. In organisational improvement, we think in quantum leaps but mostly implement in small steps. This package will help ensure that clinical governance implementation is carried out with more confidence and impact.
Emphasis is placed on the needs of patients and creating mechanisms to listen to their views. Clinical governance must service the needs of patients and not be some kind of disconnected bureaucratic exercise. Examples illustrate how patients can become involved. The precondition of cultural change in the NHS is made clear if clinical governance is to fulfil the promise of improved patient care.
The book includes references to many facets of clinical governance, including the seminal Organisation with a Memory, the developing NHS performance assessment framework, the National Institute for Clinical Excellence and the Commission of Health Improvement. Those who are so inclined will follow up references to the underpinning management thinking, including complexity theory, continuous quality improvement methods and root-cause analysis.
Abandoning Samuel Goldwyn's advice to '..never prophesy, especially about the future', I suggest that, when a history of the NHS is written in 2020, the period beginning 1997 will be described as the time when the Department of Health began to discover the importance of clinical governance and its role in the deliberate, continuous improvement of patient care. This includes how NHS quality is measured. The period will also be remembered as the most exciting and challenging time to work in the NHS. Improvement in the quality of patient care must move to the top of the agenda, alongside the more easily measured dimensions of cost and access; is it in your organisation? The extent to which this is achieved will determine if there is an NHS in 2020. Applying Clinical Governance: a practical guide for managers will help ensure that there is.
Peter Homa Chief executive, Commission for Health Improvement.