Clinical Governance and Risk Management

Clinical Governance and Risk Management have become increasingly important over the last decade in the various fields of nursing. The development of the concept of clinical governance will be discussed and how it can be facilitated into practice with relation to learning disabilities nursing. Clinical Governance was first introduced in the White Paper ‘The New NHS: Modern, dependable’ (DoH, 1997). Donaldson (1998) viewed clinical governance as the vehicle to achieve, locally, continuous improvements in clinical quality, which will aid the government’s agenda for modernisation of the NHS. This modernisation includes improving services such as clinical audit, clinical effectiveness programmes and risk management. Donaldson was among many authors in 1998 that contribute to literature, which supported the need for clinical governance at a time when the standards and quality of healthcare provision were in decline. Risk management and assessment will be discussed in relation to learning disabilities to include disabled children in the child protection system. High quality risk assessments and risk management strategies are essential for children and adolescents with disabilities. It will be shown that barriers faced in the assessment process often lead to disabled children being discriminated against in the child protection system.

To understand the development of clinical governance, we must firstly gain knowledge of its origins. During the early 1990’s, government documents and a series of high profile medical disasters such as the National Health Service (NHS) failures in bone tumour diagnosis and in paediatric surgery in Bristol helped to bring quality improvement to the top of the White Paper agenda (Nicholls, S et al 2000). The Patient’s Charter (1992) and The Citizen’s Charter (1993) are documents that drew the publics attention towards the quality and standards of care been delivered by the NHS. Both these charters gave rise to informing and empowering