Who is leading and managing change and organisational development?
Initially, for many primary care groups, clinical governance was seen as roughly synonymous with audit and clinical effectiveness. In many cases, doctors and nurses with a history of involvement in audit or postgraduate education were assumed to be technically competent and were appointed as leads. However, both large business corporations and the NHS have lost millions of pounds because they saw the establishment of, for example, new information management and technology systems as a purely technical task. Political awareness and the ability to work with colleagues with diverse values and competencies is a prerequisite for anyone promoting change. Clinical governance leads need to know when and how to “sell” the changes in behaviour that are required, and they need to use terms that will appeal to the ethos of the health professional, the small business person, and the primary healthcare team.
