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In this webinar, Nicole and Megha described the important links between clinical governance and good clinical care outcomes.

They showed how clinical governance is embedded within the strengthened Aged Care Quality Standards. Using scenarios, they present how aged care providers can meet their clinical governance responsibilities. View the presentation, as well as answers to the Q&A below.

Here are the key insights:

Clinical governance: a system, not just a standard

A central theme focuses on moving beyond viewing clinical governance as a standalone requirement (Standard 5 in the new Aged Care Quality Standards). Instead, providers should understand it as a system that underpins all aspects of safe, effective, and person-centred care.

Nicole Grey emphasises that clinical governance is a framework of accountability that must reach across an organisation, from executive leadership to point-of-care staff. It’s about the systems, culture, and capability required to monitor and continuously improve clinical care outcomes.

“Clinical governance is the system through which organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care. It’s not just about having policies—those policies need to be reflected in everyday practice,” says Nicole. 

NEW EXPECTATIONS UNDER STRENGTHENED STANDARDS

The strengthened Quality Standards introduce clearer expectations for how providers must operationalise clinical governance. For aged care services, this means ensuring:

• Clinical risk is identified and managed proactively, particularly in more complex care environments.
• Clinical governance systems are integrated across governance, management, and care delivery.
• Consumers and representatives are meaningfully engaged in planning and decision-making.
• Workforce roles and responsibilities are clearly defined, particularly concerning clinical oversight and escalation.

Megha Kalra explains that audit teams increasingly see gaps where governance processes exist on paper but are not embedded in practice. For example, providers may have policies for recognising deterioration but lack the training, escalation pathways or clarity of decision-making to implement them effectively. 

INSIGHTS FROM THE REGULATOR: COMMON CHALLENGES AND LESSONS

Drawing on case examples from the Commission’s regulatory work, Nicole and Megha highlight several recurring issues:

• Lack of timely clinical response to health deterioration, especially when there are delays in escalation or uncertainty around roles.
• Inconsistent clinical oversight, particularly in services primarily delivered by personal care workers or support staff.
• Limited engagement with consumers in understanding their clinical needs, preferences, or goals of care.
• Data collection without follow-through, where incidents or audits are logged but not analysed to drive change.

“A strong clinical governance framework enables providers to proactively identify risks, support their workforce, and deliver safe, person-centred care. One of the most common issues we see is the lack of clear escalation pathways—staff often don’t know when or how to escalate concerns, particularly in complex care situations,”  Megha notes. 

PRACTICAL ADVICE FOR AGED CARE PROVIDERS

Nicole and Megha provide several practical strategies to support effective clinical governance:

1. Embed escalation pathways into everyday practice
   Staff should be confident in knowing when and how to escalate concerns, including clinical deterioration, behavioural changes, or consumer distress. This includes access to clinical advice when registered clinicians are not on-site.
    
2. Connect governance with leadership and culture
   Clinical governance doesn’t work in a vacuum—it relies on a culture where safety is prioritised, and accountability is modelled by leadership. Boards and executives should regularly review quality metrics, discuss risks, and ensure follow-up.
    
3. Prioritise the proper training and supervision
   Education needs to go beyond compliance to focus on capability. Ensure that care staff understand the why—not just the how—behind policies and procedures. Clinical supervision and mentoring can help build this confidence.
    
4. Use complaints and feedback as signals for improvement
   Instead of viewing complaints as isolated events, treat them as part of the broader picture of safety and quality. Patterns in feedback often point to systemic gaps that need attention.
    
5. Integrate clinical governance into strategic planning
   Include clinical quality data and governance performance in strategic reviews, not just operational reporting. Align clinical governance with your organisation’s broader mission and goals.

FINAL THOUGHT: CLINICAL GOVERNANCE AS A SECTOR-WIDE IMPERATIVE

As aged care continues its reform journey, clinical governance will remain a cornerstone of safe, respectful, and responsive care. The strengthened Quality Standards offer an opportunity to align governance structures with the needs of older people and regulators' expectations.

Both Nicole and Megha reinforce that clinical governance is not a static checklist but a living system that demands leadership, engagement, and continuous reflection.

For providers seeking to stay ahead of regulatory expectations and deliver care that truly centres on the older person, clinical governance must become both a mindset and a method. Find out more about how AICG services the Aged Care sector. 

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