Clinical governance is a system for maintaining and improving the quality of patient care within the health system. It is defined as ‘a framework through which NHS organizations 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’. This definition embodies the concepts of high care standards, transparent accountability and improvement. As the name implies, clinical governance relates to the delivery of care to patients and their carers but this is also interlinked to the organization of healthcare services. The term ‘integrated governance’ is used to refer jointly to corporate governance and clinical governance within healthcare organizations.

The legal responsibility for clinical governance lies with the trust Board of each hospital, with the chief executive of the trust ultimately the person who is accountable. Although the chief executive and the trust Board are responsible, they cannot do all the work by themselves. Their role is therefore to make sure that there are structures in place to ensure that clinical governance is fully embedded at all levels. Practical responsibility for clinical governance is delegated to the medical director, nursing director, clinical directors and consultants. Ultimately everyone in the hospital is responsible for ensuring that standards of care are constantly maintained and improved. Each trust must prepare an annual quality report, summarizing the quality of care delivered and the implementation of good clinical governance.