Clinical governance: the new NHS, new responsibilities?

The declared aim of the White Paper 'The New NHS: Modern, Dependable' is to restructure the NHS so that it is based on 'partnership and driven by performance' (Department of Health (DoH), 1997). The key organizing principles are those of efficiency and excellence. Establishing a framework for clinical governance is seen as central to establishing 'an environment in which excellence in clinical care can flourish' (DoH, 1998). These new arrangements will apply to the the practice of all clinical professionals, including nurses. Clinical governance offers a new opportunity for the nursing profession to raise standards of practice without being hamstrung by issues of patient throughput and price, as was the case under the last government. However, it also presents a challenge to the frameworks within which nursing has traditionally operated. In addition, clinical governance brings with it the potential for more direct involvement of non-clinicians in professional practice.