1. VTS Scheme Presentation Dr Matt Walsh
Clinical Governance
VTS Scheme Presentation
Dr Matt Walsh

2. Who am I? GP Trainer Bradford VTS ‘graduate’
S & W Bradford PCT Director for Quality

3. Aims for the session
To assess current levels of understanding of clinical governance
To understand the history.
To improve understanding of the principles behind the concept of clinical governance
To understand some of the tools.
To test some of the tools in a practical setting.

4. What does it mean to you? What words do you think of?
How does it make you feel?
What experience have you of ‘clinical governance?’
Can you describe what ‘it’ is?

5. Clinical Governance - a Definition
“A framework through which NHS
organisations are accountable for
continually improving the quality
of their services and safeguarding
high standards of care by creating
an environment in which excellence
in clinical care will flourish”
Donaldson and Scally

6. Clinical Governance - a Definition
“A framework through which NHS
organisations are accountable for
continually improving the quality
of their services and safeguarding
high standards of care by creating
an environment in which excellence
in clinical care will flourish”
Donaldson and Scally

8. Organisation
A group of persons organized for a particular purpose; an association: a benevolent organization.
A structure through which individuals cooperate systematically to conduct business.
The administrative personnel of such a structure.

9. Accountable
Liable to being called to account; answerable.

10. Environment
The circumstances or conditions that surround one; surroundings.
The totality of circumstances surrounding an organism or group of organisms, especially:
The combination of external physical conditions that affect and influence the growth, development, and survival of organisms
The complex of social and cultural conditions affecting the nature of an individual or community.

11. In other words
The practice (and therefore the practitioner) will be called to account and asked to demonstrate on a regular basis that the quality of care for its patients is continually improving…..

12. In other words
…and to do this it will need to influence the complex of social and cultural conditions affecting the nature of the individuals and teams working with and for the practice community.

13. Quality Define what it is that we are producing?
Design and implement changes to production.
Produce it
Compare what we have produced with our standard.

14. What is the role of the GP in this?
Duties of a doctor (GMC).
Good Medical Practice (GMC).
Good Medical Practice for GPs (RCGP)
Supporting Doctors, protecting patients (DOH)

15. The Duties of a Doctor.(1)
make the care of your patient your first concern;
treat every patient politely and considerately;
respect patients' dignity and privacy;
listen to patients and respect their views;
give patients information in a way they can understand;

16. The Duties of a Doctor.(2)
respect the rights of patients to be fully involved in decisions about their care;
keep your professional knowledge and skills up to date;
recognise the limits of your professional competence;
be honest and trustworthy;
respect and protect confidential information;

17. The Duties of a Doctor.(3)
make sure that your personal beliefs do not prejudice your patients' care;
act quickly to protect patients from risk if you have good reason to believe that you or a colleague may not be fit to practise;
avoid abusing your position as a doctor; and
work with colleagues in the ways that best serve patients' interests.

18. SWOT analysis for self
Think about why you get up for work in the morning.

19. Define a quality framework for general practice.
Clinical
User
Infrastructure
Staff

20. Rules Safe environment Well chaired
Relevant information provided beforehand
About ‘I’ not about ‘you’,

21. Potential outcomes Celebrate No further action More detailed audit
Change to strategy or training plan

22. Significant event audit
‘where individual cases in which there has been a significant occurrence, not necessarily involving an undesirable outcome for the patient are analysed in a systematic way to ascertain what can be learned about the overall quality of care and to indicate changes which might lead to improvement’

23. Scenarios and feedback

24. Clinical governance Nothing new Opportunities and threats
Can support us
Brings some resources with it
Might make us feel better