ABSTRACT
An open and accountable culture in the National Health Service (NHS) allows sharing of information with the public about risks, costs and performance. Otherwise, consultation will be superficial and change will be unlikely in response to public opinion. Patient and public involvement in the planning and delivery of NHS care may occur at several levels: for patients about their own care; for patients and the public about the range and quality of health services. Involving the public in decision making about whether to accept risks or to take further action is part of the risk assessment process prior to selecting the direction of risk management. Managing and communicating risks is integral to clinical governance, whether at an individual patient level or at an organisational level. Minimising inequalities is at the heart of clinical governance, in relation to: variations in access, service provision or standards of care, and discrimination on the grounds of age, gender, ethnicity, sexuality, disability and so on.
