Everyone is accountable to patients and the community for ensuring the delivery of safe, effective and high-quality health care. This includes clinicians, managers and the governing body. Depending on the size of the healthcare service, multiple roles may be carried out by the same individual.

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This table from the Clinical Governance Framework explains the different roles within an organisation and their responsibilities when it comes to clinical governance.

• Patients and consumers participate as partners to the extent that they choose. These partnerships can be in their own care, as well as in organisational design and governance
• Clinicians work within, and are supported by, well-designed clinical systems to deliver safe, high-quality clinical care. Clinicians are responsible for the safety and quality of their own professional practice, and professional codes of conduct include requirements that align with the Clinical Governance Framework.
• Managers (including clinical managers) advise and inform the governing body, and operate the organisation within the strategic and policy parameters endorsed by the governing body. They are primarily responsible for ensuring that the systems that support the delivery of care are well designed and perform well.
• The Governing body is ultimately responsible for ensuring that the organisation is run well and delivers safe, high-quality care. It does this by establishing a strong safety culture through an effective clinical governance system, satisfying itself that this system operates effectively, and ensuring that there is an ongoing focus on quality improvement.

As mentioned earlier, the Australian Commission on Safety and Quality in Health Care is responsible for developing the National Model Clinical Governance Framework. As a commissioner of healthcare services, Primary Health Tasmania has a role to play in supporting commissioned providers with materials such as this training program. Ultimately each commissioned provider is responsible and accountable for their internal clinical governance practices.

Clinical governance, like corporate and project governance, is everyone’s business.  It is not a ‘tick and flick’ approach that is responded to in monthly meetings, only to be ignored the rest of the time.  

PHT believes that safety and quality is everyone’s business. Clinical governance is central to safety and quality, and safety and quality is everyone’s business.

In most small to medium practices and organisations, clinical governance is a part of a role within the organisation, not an individual role. So for example, in a primary care practice, it might be that the Practice Manager or Nurse Practitioner, or the Business Manager has the responsibility of managing clinical governance and ensuring that standards are implemented across the practice.

This might involve redesigning templates and policies to ensure appropriate questions are asked of patients to provide quality care, developing a Consumer Charter with community members and patients. It could involve working with the partners or Board to obtain a formal commitment to the requirements. Ultimately, clinical governance responsibilities will be across all layers of the practice so while one person might be the lead, it is also everybody’s role to contribute positively to this domain.

Source: National Safety and Quality Primary and Community Healthcare Standards