Clinical governance in radiation oncology

Clinical governance (CG) is an emerging framework that ensures accountability for delivering safe, effective, and continuously improving healthcare services. Originally introduced in the United Kingdom in the late 1990s as part of reforms in the National Health Service, CG draws upon principles of corporate governance to establish system-wide oversight of clinical quality, safety, and accountability. CG provides an overarching organisational framework encompassing leadership structures, clinical effectiveness, risk management, audits, professional development, and patient engagement. In radiation oncology, CG plays a critical role in enhancing treatment safety and quality by standardising protocols, conducting regular audits and peer reviews, implementing risk management strategies, and supporting continuous education for multidisciplinary teams. It also ensures accountability through transparent reporting to regulators, collaboration with patient groups, and commitment to evidence-based practice. Ethical principles - beneficence, non-maleficence, autonomy, and justice - are central to CG and provide the foundation for maintaining professional standards of care. Despite the increasing use of the term clinical governance, it is often only poorly understood. In the present review, we define the concept of clinical governance and discuss its role in healthcare, with a particular focus on the field of radiation oncology.