Only six per cent of top healthcare professionals are confident that managers have 'sufficient powers' over healthcare teams to tackle poor clinical practice.
That emerges from a snapshot survey by the Institute of Health Services Management of 91 senior clinicians and managers who attended their one- day conference on clinical governance.
Respondents showed overwhelming support for the concept of clinical governance, with more than half saying it would benefit the quality of patient care.
But 28 per cent of respondents said managers do not have sufficient powers to improve poor clinical practice, while 51 per cent said managers powers were limited to 'certain cases'.
More than 70 per cent thought that managers needed 'some' or 'a lot' of extra powers to make clinical governance workable.
Just under half said they were 'concerned' about the prospect of clinical governance. Nearly nine out of ten said clinical governance would be effective only if it was backed by 'some' or 'a lot' of extra resources.
Slightly more than half felt the quality of patient care would be improved by clinical governance, but 36 per cent said such an improvement was only 'possible'.
One respondent criticised 'simplistic directives from the Department of Health and central government which ignore the complexity of setting up, implementing and monitoring clinical governance across a wide range of professions and areas of practice.'
Another suggested managers needed powers 'to cut through some of the 'red tape' associated with traditional disciplinary processes' if governance is to work.
IHSM deputy director Suzanne Tyler said the findings showed that clinical governance has the backing of healthcare teams.
She added: 'But it also confirms that there are serious concerns about whether clinical governance can become 'a successful reality. More resources and more information are crucial'.
Ms Tyler said 'neither managers nor clinicians alone' could cope with the size of the task ahead.
'It needs to be a team effort and this will require a culture change in addition to greater collaboration and communication.'