Editorial

Citation

Gillies, A.C. and Harrop, N. (2016), "Editorial", International Journal of Health Governance, Vol. 21 No. 1. https://doi.org/10.1108/IJHG-12-2015-0034

>Editorial

Article Type: Editorial From: International Journal of Health Governance, Volume 21, Issue 1.

Clinical Governance: hail and farewell

In this issue, we bid farewell to Clinical Governance an International Journal and hail The International Journal of Healthcare Governance, welcoming and wishing success to its new editors.

At the commencement of our own term as editors, we had three goals. First, we hoped our journal would reflect critically and contribute to, the corpus of knowledge about clinical governance; this was challenging for two principal reasons. To begin with, clinical governance is an evolving field and its field of application, in the health services of the countries where it has taken root, is also continuously evolving as new policies, administrations and challenges emerge and progress through their life cycles, from novelty and salience to senescence and obscurity. In addition, clinical governance originated as a concept with particular relevance to the UK; its components and the concerns it was intended to address were not uniformly replicated or appreciated across the geographical span of the journal’s readership and contributorship.

Second, we aimed to develop the international scope of the journal’s outlook. We have published papers from sources which, from our UK perspective, both surprised and pleased us. These have demonstrated a concern for the general concept of healthcare governance existing in the Middle-East, South-East Asia and the Indian sub-continent as well as in Northern America, Australasia and the Republic of Ireland, whence we naturally expected contributions. As articulated in the UK, clinical governance has a specific set of meanings, set out in seminal literature and in the institutional literature of the NHS. We have gained the impression that this set of meanings is not widely shared in non-Anglophone Europe. In advancing this hypothesis, we have hoped to invite well-informed, well-argued contributions which will demonstrate how the principles enshrined within the clinical governance concept have been applied to the governance of healthcare in these areas of the globe, and explore the forms of governance which prevail.

Third, we aimed to provide a showcase for, and explore the learning from, specific local clinical governance initiatives. This would contribute to the corpus of useful knowledge and appeal to an academic and a policy-making audience as well as to clinicians and managers.

From our own academic and clinical backgrounds, we have been keen to develop an appreciation of information governance and the value of information to governance. In the tradition of influencing policy, we are proud that one of us (AG) has been able to participate in the work of the Care Quality Commission’s national information governance committee and publish reflections on its work, making practical contributions to national policy for information governance in healthcare and, thereby, to the governance of healthcare generally.

Since the inception of clinical governance, the UK has learned painful lessons from the appalling constellation of professional and managerial failures which precipitated the Mid-Staffordshire Hospitals public inquiry. The 290 recommendations of the inquiry reversed the subordination of clinical to institutional and managerial concerns; they asserted that the concerns and welfare of individual patients must not be sacrificed for compliance with targets and performance indicators. They gave preference to direct inspection and observation of care in healthcare facilities over the analysis of summary control data and were critical of the interaction between the various regulatory bodies charged with supervision on either side of the purchaser-provider split in the UK’s quasi-market for commissioned, public-funded healthcare. We conclude that the new professionalism represented by “clinical governance” remains relevant and we anticipate that “healthcare governance” will have extensive resonance across the world, irrespective whether the public purse or the insurance pool is the funder.

Alan Cameron Gillies and Nick Harrop