1. Clinical Governance VTS Scheme Presentation Feb 2003 Matt Walsh

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

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

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

5. 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 Clinical Governance - a Definition Donaldson and Scally

6. 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 Clinical Governance - a Definition Donaldson and Scally

8. Organisation A group of persons organized for a particular purpose; an association: a benevolent organization. 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. Liable to being called to account; answerable.

10. Environment The circumstances or conditions that surround one; surroundings. The circumstances or conditions that surround one; surroundings. The totality of circumstances surrounding an organism or group of organisms, especially: 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 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. 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….. 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. …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? Produce it Compare what we have produced with our standard. Design and implement changes to production.

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

15. The Duties of a Doctor.(1) make the care of your patient your first concern; make the care of your patient your first concern; treat every patient politely and considerately; treat every patient politely and considerately; respect patients' dignity and privacy; respect patients' dignity and privacy; listen to patients and respect their views; listen to patients and respect their views; give patients information in a way they can understand; 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; respect the rights of patients to be fully involved in decisions about their care; keep your professional knowledge and skills up to date; keep your professional knowledge and skills up to date; recognise the limits of your professional competence; recognise the limits of your professional competence; be honest and trustworthy; be honest and trustworthy; respect and protect confidential information; respect and protect confidential information;

17. The Duties of a Doctor.(3) make sure that your personal beliefs do not prejudice your patients' care; 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; 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 avoid abusing your position as a doctor; and work with colleagues in the ways that best serve patients' interests. 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. Think about why you get up for work in the morning.

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

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

21. Potential outcomes Celebrate Celebrate No further action No further action More detailed audit More detailed audit Change to strategy or training plan 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 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 Nothing new Opportunities and threats Opportunities and threats Can support us Can support us Brings some resources with it Brings some resources with it Might make us feel better Might make us feel better