ABSTRACT
This chapter explores the relatively new concept of clinical governance. It is concerned with quality improvement; clinical governance must also tackle poor performance in both individuals and teams. Responsibility for implementing clinical governance was given to the new primary care groups and primary care trusts. Three distinct groups are involved in the delivery and audit of quality care, namely clinicians, managers and patients. If clinical governance is to be completely successful, then quality improvement must involve each of these groups, and their different perspectives, as far as is possible. One of the challenges for the profession posed by clinical governance is the recognition and development of leadership within practices and groups. Successful implementation of clinical governance is a key factor in maintaining the privilege of self-regulation. Peer appraisal should involve helping the other to improve, rather than merely trying to unearth poor performance.
