Advancing clinical governance Edited by Myriam Lugon and Jonathan Secker-Walker Royal Society of Medicine Press 215 pages£18.50

This is a follow up to Clinical Governance - Making it Happen. Chapters by leaders in their fields examine the significance of clinical governance for a range of participants: patients, chief executives, nurses, midwives and medical directors.

Although these are well written and informative, the balance between assessing the environment, practical tips and examples varies. A more consistent structure would have been more helpful.

There are some chapters of a quite different sort: learning from complaints, how clinical governance sits in organisations, how evidencebased practice fits into the scheme of things, clinical information, clinical governance in primary care groups, the National Institute of Clinical Excellence, revalidation and controls assurance.

As well as clinicians, the book is intended for managers, healthcare purchasers and academics. It makes a good attempt to reach multiple audiences, but this inevitably makes it less of a practical guide and more a 'general principles and overview'.

It describes itself as enabling health professionals to implement clinical governance effectively and with confidence. This is perhaps claiming a little too much. It is more likely to be introductory reading for someone taking up new responsibilities in clinical governance, or a refresher for someone who thinks that it is time to take a step back.

The problems of trying to meet a variety of needs is reflected in the way the book is ordered and the different coverage of each subject. For example, the chapter on patients is separated, for no good reason, from a cluster of chapters involving stakeholders by one on organisations.

This is a good book: it is interesting, varied and useful, but not one to help those who are trying to push their way through the brambles and emerge into the open fields.

If you are interested in clinical governance as a student or an observer, or if you want to get your bearings, this is a good place to start; if you want a 'how to' guide because you have to get the 'how to' right this year, it is not.

The real world tends to throw up situations that are untidy, difficult to classify, irrational and resistant to obvious remedies. Clinical governance is the art of management, of interpersonal relationships, of charisma, of leadership, of cunning even. You can't expect to get all that from just one book.