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It is 10 years since Robert Francis presented the report on the public inquiry into failings at Mid Staffordshire NHS Foundation Trust. The government’s response signalled a determination for change. It promised wide-ranging interventions and legal and regulatory reforms to tackle problems of culture, openness, and willingness to learn. What is the impact 10 years on?
The concept of candour is not new. Being candid means being honest, which includes ‘complete openness and transparency.’ Exercising candour in healthcare is challenging for multiple reasons.
‘Successful integration is the planning, commissioning and delivery of co-ordinated, joined up and seamless services to support people to live healthy, independent and dignified lives and which improves outcomes for the population as a whole. Everyone should receive the right care, in the right place, at the right time.’
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The term ‘clinical governance’ was first coined in the context of the National Health Service (NHS) in the United Kingdom, being ‘a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.'
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From its inception as a concept, clinical governance has learned from failures. A landmark inquiry into the deaths of over 30 children at the Bristol Royal Infirmary between 1991 and 1995 (Bristol Inquiry) was an early exemplar of how learning from errors can inform improvements to safety and quality, and hence clinical governance.
Clinical governance (the concept of which emerged in the 1990s in the context of health care) has traditionally attracted less attention in the care of people living with a disability, with a noticeable dearth of research specific to this sector. Such oversight has been highlighted in the recent draft report by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (Disability Royal Commission), which inquired into the Federal Government's approach to the rollout of COVID-19 vaccines to disability care residents and workers.
