So... What can you tell me about clinical governance?

 Updated 2nd Jan 2021

That dreaded question!  Whether in an interview situation or on the job, it's important that you have the elements to answer it. After all, it's what allows us healthcare professionals to continue delivering high standard of care...


Clinical governance is defined as a systematic approach to maintaining and improving the quality of patient care within the National Health Service.

This simple definition doesn’t necessarily make it clear what is required of us as health care professionals to maintain or improve quality in our work, but it does give us an idea of what we need to talk about: it is a framework that keeps the NHS as an accountable for continually improving the quality of our services, and safeguarding high standard of care by creating an environment that allows excellence and improvement to flourish.

Sounds easy right?

Here are some examples of day to day practice that fall under the heading CG.


Information governance, i.e the direct handling, collection and storage of patient data. The legal framework associated with IG is complex, it includes the NHS Act 2006, the Health and Social Care Act 2012, the Data Protection Act, and the Human Rights Act. Whilst you don’t need to know the ins and outs, know about the main principles of data protection. Much of it is common sense but there are some specifics to learn. 

The law allows personal data to be shared between those offering care directly to patients but it protects patients’ confidentiality when data about them are used for other purposes. These “secondary uses” of data are essential if we are to run a safe, efficient, and equitable health service. They include:

  •     Reviewing and improving the quality of care provided
  •     Researching what treatments work best
  •     Commissioning clinical services
  •     Planning public health services

Generally speaking, people within the healthcare system using data for secondary purposes must only use data that do not identify individual patients unless they have the consent of the patient themselves.

Duty of candour / openness. Poor performance and practice can often persist behind closed doors - and we can often get comfortable with how we perform if we are not subject to regular constructive criticism and review. We have a duty to be honest to our patients if we make a mistake and saying ‘I am sorry’ for something is no longer necessarily an admission of guilt in a legal sense. It is about being honest, open and up front with paitents.

Education and training - basic CPD. We have a duty to ensure our practice is up to date as individuals and as an organisation.

Clinical audit - regular reviews of our clinical performance. Are we meeting our benchmarking standards? 

Clinical effectiveness - do our interventions work? Are they cost effective and justified? Do we have research to justify what we do?

Research and development - a desire to change our practice to meet evidence led research. The time lag between publication and actual change is often long, and the reasons for this are complex. We work as part of a multidisciplinary team and we do not always communicate very well together, surgeons like doing surgery, physios like doing physio etc. Inter team training and communication is important.

Risk management, we need to consider risk to the patient in terms of time and physical / social and psychological harm. Risk to the practitioner in the same way and risk to the organisation - a hospital needs to make money to be sustainable, but this cannot come at the expense of the patient or practitioner experience.


GDPR – heard of it? You better! The General Data Protection Regulation was introduced by the EU in May 2018 to protect the public against how businesses collect, store and use our data.

Despite Brexit, GDPR has ‘extra-terrestrial reach’ meaning it applies to non-EU countries as long as they are intending to do business with the EU. This will include the NHS and how it handles data on EU citizens in the UK after Brexit. Failure to comply has been fined severely up to 4% of global turnover or €20 million, whichever is greater(!).





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    About the author 

    Nicolas Colombo      

    Nic works as a Senior Physiotherapist both in a busy NHS hospital in East London and privately. Since he qualified, he has gained a large amount of experience assessing and treating various conditions, but also meeting and working alongside all sorts of healthcare professionals. He set up QualifiedPhysio with the idea of making available to future and new physios all the advice, guidance and resources he got along the way, to bridge that gap between Uni and their first job.