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Wednesday, March 31, 1999 Published at 14:10 GMT 15:10 UK


Clinical governance to ensure quality

Surgeons have already embraced clinical governance

Most of the government's measures are designed to ensure higher standards. Central to this is the concept of clinical governance.

This essentially means doctors taking responsibility for their actions and ensuring treatment meets a quality benchmark.

The government says this means the public can have more faith in the medical profession.

The Government will help ensure national quality standards are applied consistently within local practice through a new system of clinical governance.

The new NHS
This will be the process by which each part of the NHS quality-assures its clinical decisions.

Under this system, health workers will be legally obliged to provide quality care.

They will also have to take part in a new system of life-long learning to ensure that their skills are kept up to date, and that they have the opportunity to develop new areas of expertise.

Two weeks ago, the government announced guidance on clinical governance, setting out how health organisations can ensure they are providing quality care.

In April, it will publish the first hospital league tables on clinical performance.

These will allow people to see whether different hospitals meet national standards regarding the outcome of particular operations.

The government also plans to modernise the system of professional self-regulation to root out sub-standard care.

Ministers want to ensure that self-regulation more closely reflects the concerns of the public, and that the system is made more open and accountable.

In the 10 months since the conclusion of the General Medical Council (GMC) hearing into the Bristol heart babies scandal, doctors have been taking steps to improve practice.

In February, the Royal College of Physicians issued a five-point plan to ensure professional quality.

It said existing ways of regulating the medical profession were no longer good enough, and that the public expected more accountability from doctors and less variation in standards of practice and behaviour.

Its move followed the launch of proposals for tightening the regulation of doctors announced by the GMC.

It proposes preventing doctors from practising medicine at the highest level if they fail to prove their skills are up to date.

Under the RCP proposals, consultants and specialists will have to prove their competence to a standards adviser.

While the RCP cannot stop doctors practising, it can step in to identify under-performers and take action to improve standards.

In some cases, it can also arrange early retirement for doctors who do not come up to scratch. It can also refer on to the GMC for disciplinary action.

The RCP plan follows a report last October from the Senate of Surgery of Great Britain and Ireland which called for doctors to undergo regular tests of their skills.

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