ABSTRACT
This chapter considers the clinical governance of health services as institutions. It considers what one can learn from governance concepts, knowledge and failures in non-health settings. The chapter brings into perspective the challenges of governing safety and quality of health care at an institutional level, with a particular focus on the key role of specialist medical practitioners in clinical governance. It also considers the relationship between corporate governance and clinical governance; the elements of good governance generally; some of the drivers of conduct and performance in hospitals; barriers to good governance; the structure of the public health care sector and its implications for good governance; the availability of clinical governance tools and techniques; and the future of clinical governance. The modern health service is a large, complex and diverse organisation, often operating over multiple sites, which continues to be challenged by the increasing complexity and diversity of care.
