The concept of clinical governance has been around for a long time. It was the ssubject of an NHS white paper of the late 1990s and was put in place to tackle differences in quality of care throughout Britain. In particular, it was a response to specific major failures in NHS standards.

As far back as 1998 Scally and Donaldson set out this vision of clinical governance: “A framework through which NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.”

Clinical governance aims to shift the performance of all health organisations closer to the standards of the best. It hopes to reduce unjustifiable variations in quality of care provided (as measured in terms of outcomes, access and appropriateness) and, when publicised, act as a reassurance to the public that the care they receive is of the highest quality and in line with best practice standards.

Clinical governance has been included in the Community Pharmacy Contractual Framework since 2005. In the context of the Community Pharmacy Contractual Framework, clinical governance includes all of the following:

• Patient and public involvement
• Clinical audit
• Risk management
• Clinical effectiveness programmes
• Staffing and staff management
• Education, training and continuing professional development, and personal development
• The use of information to support care delivery.