Clinical governance and clinical supervision: protecting standards of care

The government document A First Class Service – Quality in the New NHS (Department of Health, 1998) stated that one of the key strategies for achieving quality was the introduction of clinical governance, and as Scott noted (above) this would require a fundamental change in culture. Sadly, while there has been a significant change in culture it has had little to do with quality, as recent media coverage in the South of England, and numerous anecdotes testify. It is important to remember, when despairing over such displays of the most blatant abrogation of standards, that there are people doing fine work in the NHS, but it is also important to scrutinise carefully that which has put management and nursing in a very bad light, and to consider how this might have been avoided. What are the lessons to be learned? One wonders why qualified nurses with an accountability to both their profession and to the State struggle on when conditions for patients are so appalling? A misguided notion of not letting people down? A fear of whistle-blowing? Whatever the reasons – and no doubt they are as varied as the staff involved – the highly exposed weakness of nursing need to be examined. It is highly relevant to note that in the recent White Paper (Secretary of State for Health, 2007) proposals are made to strengthen continuing professional development, amongst other measures aimed at improving performance in general, as well as eliminating poor performance more effectively than in the past.These proposals must be welcomed and concur with the views of Scott (1999: 173) who stated that for clinical governance to be successful: