ABSTRACT
Introduction The NHS was established to provide healthcare for those who need it, free at the point of delivery and funded by taxation. No formal quality agenda existed until 1983 when the Griffiths report noted a lack of accountability for quality at the local level and subsequently clinical staff were drawn into management teams with responsibility for service quality. The New NHS, Modern, Dependable,1 published in 1997, was the first government white paper to address issues of quality and effectiveness and announced the establishment of two organizations: ●● the National Institute for Clinical Excellence (NICE) (now the National Institute for Health and Clinical
Excellence) to develop and publish national evidence-based guidelines applicable across the NHS ●● the Commission for Healthcare Improvement (the Care Quality Commission since 2009) to ensure the
NHS maintained high-quality, safe healthcare. In 1998 A First Class Service: Quality in the NHS2 set out a strategy to create a ‘modern health service that delivers high quality care for all’. The core concept of clinical governance was introduced to ensure high standards were achieved and the NHS would be ‘more open and truly accountable to the public’:3
Clinical governance is 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.
