Clinical governance is widely recognised as the mechanism for ensuring the safety and quality of patient care. Good governance is the means of supporting the early identification of risks and concerns that lead to individual, team and wider organisational learning. Having a culture of good governance has been the focus of many recommendations following inquiries into poor care – from Mid Staffs to Morecambe Bay.
While most of the care falls around the middle of the quality curve. Clinical governance aims to shift the performance of health and care organisations closer to the standards of the best and reduce the variations in the quality of care provided. It is needed to reassure the public that the care received is of the highest standard.
Good governance requires the "development of a culture where healthcare professionals are motivated to routinely think: Am I doing it right? How can I do better?"
New clinical governance handbook
The General Medical Council has recently published Effective clinical governance for the medical profession: A handbook for organisations employing, contracting or overseeing the practice of doctors. The handbook has been designed for those individuals or groups of individuals who play an important leadership role in delivering and assuring the quality of clinical governance processes for doctors.
In the main, this will be the board or governing body of a health and care organisation but it may also include owners of independent sector organisations and, in some circumstances, individual doctors. Anyone involved managing and delivering clinical governance will also find the handbook a useful resource.
The guide was first published in 2013 after the introduction of revalidation – the process through which doctors show they are up-to-date and fit to practise. Changes in the revised version reflect learning and system developments from the first five years of revalidation.
Signatories to the handbook

What is its purpose?
Designed to provide boards with a description of the core principles underpinning effective clinical governance for doctors focusing particularly on responsibilities in the Responsible Officer regulations. The guide acts as a resource to support organisations in evaluating the effectiveness of their local arrangements in areas such as:
- leadership, delivery and quality of clinical governance for doctors
- medical revalidation
- identifying and responding to concerns about doctors
- pre-employment checks for doctors
It is worth noting that responsibility for and delivery of various aspects of clinical governance for doctors are different across the UK, sectors and type of organisation – they are dependent on whether an organisation acts at a local or national level. It should also be used with other relevant clinical governance guidance.
There is no requirement to report against the handbook but organisations may find it useful to record how it has been used in practice when preparing for future CQC inspections and internal audit work. It may also be used as an aid to annual board reporting.
Jog Hundle, Partner