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Individual doctors and clinical governance - Achieving an appropriate balance of support and challenge in hospital medicine

Lookup NU author(s): Catherine O'Halloran


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It could be argued that the very success of British medicine is built on the independent nature of consultant practice. The role as individual practitioners, with considerable control over decision making has been helpful in encouraging innovation and independent thought, and thus maximising the quality of work. Sadly, however, this high level of independence has allowed considerable variation in standards of patient care, with some individuals delivering a poor quality service. Whatever clinical governance brings, we must ensure that we work to maximise the effectiveness of individuals within the organisation, and not diminish the effectiveness of current practice arrangements by excessive and over-bureaucratic control. Clinical governance provides us with an opportunity to create an environment in which excellent clinical care is encouraged to develop and flourish. The wholehearted commitment of individual doctors is pivotal to its success. To achieve this, each individual's working environment should provide a balance between support and challenge. The daily work of medicine, in which we are involved in the health, and sometimes the life, of patients in our care, involves considerable challenge. By balancing this with appropriate opportunities for reflection and support, an organisation, and the individuals within it, should be able to develop a culture of openness, creativity, corporacy, commitment and innovation, which will lead to effective professional self-regulation, life-long learning and consistent high quality in health care.

Publication metadata

Author(s): Redfern N, Bynoe G, Connor M, O'Halloran C, Pokora J

Publication type: Review

Publication status: Published

Journal: Clinician in Management

Year: 2000

Volume: 9

Issue: 3

Pages: 169-176

Print publication date: 01/01/2000

ISSN (print): 0965-5751

ISSN (electronic): 1475-9926