Clinical governance is the process by which high quality services are delivered to patients. It is made up of a number of tools which enable individual pharmacists, their managers and their employers to recognise and celebrate good professional practice and to highlight areas that require improvement.
Engaging with clinical governance and its processes, including continuing professional development (CPD), will help pharmacists to maintain and improve the quality of pharmacy practice.
In addition to England, the health services of both Scotland and Wales have adopted the concept of clinical governance. For the purposes of clinical governance the term "NHS organisations" has been interpreted to mean organisations where services are provided to NHS patients, and therefore includes community pharmacies.
This website contains a number of resources to help pharmacists and their staff with developing clinical governance systems and practices.
To apply to become a member of the Society's discussion forum for clinical governance facilitators, contact:
e-mail: qualityimprovement@rpsgb.orgClinical governance is defined as "A framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish."
Clinical governance is the "how to" part of a broader quality improvement agenda for the National Health Service, which includes setting standards via the National Institute for Health and Clinical Excellence (NICE) and national service frameworks (NSFs), and the monitoring of standards by the Healthcare Commission and others.
There is no single task which is clinical governance but there is a series of processes which, when undertaken individually, build up the picture that is clinical governance. These processes are:
For more background information, see An organisation with a memory
The Society expects all pharmacists to participate in clinical governance to ensure high quality services for all patients and the public. Clinical governance involves learning not just from what worked well but also from what went wrong, and learning how to prevent incidents happening again. For this, pharmacists need to learn from each other and to encourage a fair and open culture where they share their experiences to promote best practice for all patients.
All the processes in clinical governance can be linked directly to the Royal Pharmaceutical Society's Code of Ethics and Standards. To this end, the Society requires pharmacists to develop all service specifications using the tenets of clinical governance.
This can be summed up in a statement in the report of the Bristol children's heart surgery inquiry: "A patient is entitled to be cared for by healthcare professionals with relevant and up-to-date skills and expertise". Every healthcare professional needs to ask: "How can I prove that I am up to date if I am asked to do so?" The answer is through clinical governance.
For the report of the public inquiry into children's heart surgery at Bristol Royal infirmary 1984-1995, click here
The Royal Pharmaceutical Society of Great Britain and the NHS Clincial Governance Support Team, with support from other organisations, have developed a unique e-learning programme on the components of clinical governance and what it means to community pharmacists. For more information and to access the free training modules, click here
The Royal Pharmaceutical Society of Great Britain has produced guidance for pharmacists advising on the recording of interventions to help ensure patient safety and improve quality of care.
Click on the link below:
Guidance on recording interventions (April 2006)
The Royal Pharmaceutical Society of Great Britain has produced guidance to assist pharmacists whose pharmacies are visited by representatives of external monitoring bodies. The new pharmacy services regulations in England and Wales allow various local and national bodies to arrange monitoring visits to any pharmacy that holds an NHS contract.
Guidance for pharmacists in England and for pharmacists in Wales was published in The Pharmaceutical Journal in January 2006.
Click on the links below:
Visits to pharmacies in England by external monitoring bodies
Visits to pharmacies in Wales by external monitoring bodies
The Royal Pharmaceutical Society of Great Britain has produced a document listing resources supporting the community pharmacy contract.
Click on the link below:
National resources available to support the community pharmacy contract (England and Wales) (revised January 2006)
The Royal Pharmaceutical Society of Great Britain and the NHS Clinical Governance Support Team have produced a document mapping links between the 2004 NHS standards for better health and the new community pharmacy contract for England and Wales.
Click on the link below:
Clinical
governance, standards for better health and the new community
pharmacy contract (England and Wales). Making the links
(revised February 2006)
The Royal Pharmaceutical Society of Great Britain has published a Clinical governance framework for pharmacist prescribers and organisations commissioning or participating in pharmacist prescribing (GB wide) to ensure that patient safety is an integral part of pharmacist prescribing.
Click on the link below:
The Royal Pharmaceutical Society of Great Britain is aware that many organisations are setting up poor performance schemes as part of their clinical governance arrangements. The guidance that follows is intended to assist organisations to recognise poor performance and outlines the principles which employers, including the managed care sector (NHS), should apply in identifying and remedying poor performance.
The Society is issuing this document as interim guidance because the Government's response to the recommendations of the Shipman Inquiry Fifth Report (Safeguarding Patients: Lessons from the Past- Proposals for the Future) may have implications for local poor performance schemes. The Society will review this guidance in the light of any changes proposed by the government. However, in the interim period the Society is keen to ensure that local pharmacist poor performance schemes operate in an effective, consistent manner and help promote the safe effective delivery of pharmacy services for patients and the public.
Click on the link below:
Identifying and remedying pharmacist poor performance in England and Wales
We are seeking comments from pharmacists and others on this interim guidance. We are particularly interested in comments on how the guidance could be improved and any practical problems that can be identified.
Please send your comments to:
e-mail: qualityimprovement@rpsgb.org
A report on the role of clinical governance facilitators working with community pharmacists was published by the Royal Pharmaceutical Society in July 2003.
Click on the link below:
Beyond the baseline: The role of clinical governance facilitators working with community pharmacists
For the Welsh version of the report, launched in January 2004, click here
The Society has written a policy paper on clinical governance in pharmacy. This paper - Achieving excellence in pharmacy through clinical governance - outlines the framework that needs to be in place locally for clinical governance to be successful. It also outlines where pharmacists need support and makes recommendations to pharmacists, health authorities and others.
We have produced two versions of this policy, as PDF files. One applies to England and Wales and the other to Scotland. You can download either version using the links below.
Achieving excellence in pharmacy through clinical governance
(England and Wales version)
Achieving excellence in pharmacy through clinical governance
(Scotland version)
Clinical governance is essentially a local process. The Society is, however, supporting the development of clinical governance at a national level by developing tools that can be used locally.
The first of these is a Community Pharmacy Clinical Governance Assessment. The aim of the questionnaire is to help community pharmacists establish what they are doing about the different aspects of clinical governance.
We would like to acknowledge the work of several groups that have produced clinical governance questionnaires in community pharmacy. We drew upon their work in designing the Community Pharmacy Clinical Governance Assessment and would particularly like to mention the work of the South Cheshire LPC and Health Authority whose work inspired our own questionnaire.
You can download the Community Pharmacy Clinical Governance Assessment using the links below.
Introduction to the assessment
Pharmacist's CPD questionnaire
Guidance on completing the questionnaire
The society has also produced an Excel 97 program to analyse the questionnaire. Version 1 was made available in 2000; it has now been updated in the light of feedback. You can use the links below to download a zip file of Version 2 of the program or of an updating program. The updating program will update any data already entered into Version 1:
Analysis program, Version 1 update
The Society will continue to support clinical governance and will post further work to this website as it is completed.
The aim of this work programme would be to support the development of clinical governance in community, hospital, primary care/pharmaceutical advisers and locum pharmacy. There are several aspects to the work on clinical governance:
These areas will be dealt with to varying degrees in each area of practice.