Clinical Governance

Clinical Governance

13 PILLARS OF CLINICAL GOVERNANCE

PACCER PIRATES

Patient and public involvement

- Patient feedback forms
- Engagement events
- https://www.england.nhs.uk/wp-content/uploads/2017/04/ppp-policy.pdf
- https://www.england.nhs.uk/participation/success/case-studies/primary-care/dentalcommissioning

Access

Fair and accessible care to all groups
- https://www.nature.com/articles/4800224
Access to emergency slots

Clinical records

4C’S of note-taking
- Clear, complete, concise and contemporaneous
- https://www.theddu.com/guidance-and-advice/guides/keeping-good-records

Child protection and Safeguarding

Appropriate training
Recording of concerns
Raising concerns
- https://bda.org/childprotection/Resources/Documents/Childprotectionandthedentalteam_v1_4_Nov09.pdf

Emergencies

Needle sticks
- https://www.nhs.uk/common-health-questions/accidents-first-aid-and-treatments/what-should-i-do-if-i-injure-myself-with-a-used-needle/
Adverse incidents
- NEVER EVENTS
  - https://improvement.nhs.uk/resources/never-events-policy-and-framework/
  - WRONG SIDE ID-BLOCK IS NOT A NEVER EVENT (FEB 2020)
Medical emergencies
- https://www.nature.com/articles/bdjteam201655

Risk Management

How to perform a risk assessment
- https://www.themdu.com/guidance-and-advice/guides/montgomery-and-informed-consent

SWISS-CHEESE MODEL (RISK ANALYSIS)

https://en.wikipedia.org/wiki/Swiss_cheese_model
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117770/

Prevention and Public Health

such as use of Delivering Better Oral Health guidelines
- https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention

Infection Control

HTM 01-05 (INFECTION CONTROL)
- https://www.gov.uk/government/publications/decontamination-in-primary-care-dental-practices
HTM 01-07 (AMALGAM WASTE)
- https://www.gov.uk/government/publications/guidance-on-the-safe-management-of-healthcare-waste

Radiology and Radiography

IRR
- https://www.fgdp.org.uk/news/updated-new-regulations-x-ray-use-likely-implications-irr17-and-irmer18
- https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjNpqf8rbzrAhWGTcAKHfpZATAQFjAJegQIAxAB&url=https%3A%2F%2Fwww.sor.org%2Fprintpdf%2Fbook%2Fexport%2Fhtml%2F6674&usg=AOvVaw0xR1b4qVNjQTN3GfZ5ccPi

IRMER
- https://www.cqc.org.uk/guidance-providers/ionising-radiation/ionising-radiation-medical-exposure-regulations-irmer

Audit

Teamwork

Scope of practice
- https://www.gdc-uk.org/information-standards-guidance/standards-and-guidance/scope-of-practice
- https://www.gdc-uk.org/information-standards-guidance/standards-and-guidance/direct-access

Evidenced-based Dentistry

E.g. DBOH Guidelines
(Recommending Fluoride)

Safety

Patient safety
- COSHH
  - http://peninsuladental.org.uk/wp-content/uploads/2019/01/COSHH-Policy.pdf
- RIDDOR
  - http://training.isopharm.co.uk/blog/riddor-significant-events-reporting/

WHAT IS CLINICAL GOVERNANCE?

Clinical Governance is a way to improve the standard of care across the board within healthcare and to minimise the risk to patients.
Helps maintain and sustain high standards of patient care

Scally and Donaldson 1998, p.61)

“a system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.”

The NHS Clinical Governance Toolkit defines clinical governance as:

“Clinical governance has been defined as a system through which healthcare organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish.
Effective clinical governance ensures that risks are mitigated, adverse events are rapidly detected and investigated openly, and lessons are learned. “

USEFUL LINKS