Primary care trusts need to provide leadership training to professional executive committees and have a strategy to consult with patients, the Commons public accounts committee has concluded.

Its report on clinical governance said patient and public involvement was less well developed than other clinical governance areas.

It said: 'PCTs need to have a clear strategy for consulting patients and the public on service design and delivery.'

The report also found that clinical governance is not as well established in primary care as in secondary care.