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The term clinical governance was first coined in the context of the United Kingdom’s National Health Service - specifically, in a white paper endorsed by then Prime Minister Tony Blair entitled ‘The new NHS: modern, dependable.’ Now, 25 years later – where are we at?
 

The Royal Commission into Aged Care Quality and Safety (Royal Commission) recommended that every approved provider of aged care (whether delivering personal or clinical care) adopts a digital care management system, including an electronic medication management system, and that this should be an ‘immediate focus’ (Recommendation 68 of the Final Report).  

The Royal Commission into Aged Care Quality and Safety noted in its Final Report, presented on 26 February 2021, that aged care ‘should be able to deliver compassionate and kind care built on respectful relationships’. Person-centred care (or ‘consumer-centred’ care) was already central to the way aged care was expected to be delivered, under the Aged Care Quality Standards which have been in effect since 1 July 2019.

Join Consumer Health Forum (CHF) CEO, Leanne Wells, Senior Advocate for the Council for Intellectual Disability, Jim Simpson, and Chief Executive of COTA Australia, Ian Yates to discuss the active and growing role of consumers within our health, aged care and disability sectors.

The concept of ‘burnout’ was first described in the early 1970s, and has attracted media attention in recent years specifically in the context of healthcare. It is known to be particularly prevalent within certain demographics, compounded by the COVID-19 pandemic.  Burnout is not unique to acute health services, with evidence of its prevalence seen in other care sectors such as aged care and disability.

Clinical governance can be supported through effective regulatory design - and setting minimum standards. However, clinical governance is not just about compliance.

It has been acknowledged in the context of aged care reforms that an ‘improved approach to regulating aged care will go beyond compliance to foster a culture and practice of continuous improvement to deliver higher quality care that better supports the wellbeing of senior Australians.’ Indeed, clinical governance is aspirational, and a culture of continuous improvement should be embedded in any care organisation - not only at the point of care through to management, but also within the governing body.

There is no formula to clinical governance. While there are key components that should always be considered, how we consider them requires flexibility and agility to achieve good clinical outcomes.

Primary and community care are fundamental to population health. They support the community’s physical and mental well-being through their role in health promotion, health literacy and preventative care, as well as in the early intervention and ongoing management of acute and chronic conditions, including end-of-life care

An important aspect of clinical governance, particularly in primary and community care, is monitoring and early intervention. Particularly important in older people in the early detection of functional decline or clinical deterioration.

"Governing bodies of approved providers should be comprised of members whose integrity, skills and independence enable them to act, first and foremost, in the best interests of the people receiving care. Evidence before us has demonstrated, in particular, a lack of adequate clinical governance expertise on the boards of some providers. We consider that each governing body should have a care governance committee, to ensure that quality of care is considered at the highest level of the organisation. The chair of the care governance committee should be a member of the governing body and have appropriate experience in providing care. The focus of care should cascade from the governing body through the executive leadership to all staff."