The article by Colin-Thome (2013) addresses the UK’s clinical governance through the perspective of the newly reformed National Health Service (NHS) commissioning. The author provides a detailed description of the history of clinical governance that prioritized different aspects of healthcare at different times. As the researcher proceeds to discuss the contemporary issues related to commissioning and clinical governance in the context of the NHS reforming, he identifies inaccuracies, obstructing factors, and other problematic issues.
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The author of the article sets a well-articulated context for the problem discussed in the publication. Indeed, the understanding of the developmental path of the UK’s NHS allows for a more informed analysis of the currently applied improvements. Overall, clinical governance as a concept is aimed at the improvement of the overall healthcare system by providing the conditions for high-quality patient care through physicians’ professional advancement (Colin-Thome, 2013). While commissioning plays a significant role in the implementation of the core principles of clinical governance, the author reports on multiple drawbacks in the practical side of the process. However, although the article presents multiple accusations of ineffective implementation of clinical governance, it fails to provide recommendations for improvement or any guidance on drawbacks elimination. The researcher mentions more successful European and American systems that function more efficiently, but he does not explicitly explain how that experience might be introduced to the UK context.
Overall, the article is an analysis-based review of the observed process of the implementation of clinical governance practices in the UK. It accumulates critically important information on the importance of aligning commissioning practices with the ideas of clinical governance aimed at improved patient care, as outlined in the reform. Most importantly, the author concludes that a self-monitoring culture within the healthcare system should remerge in order to ensure the functionality of commissioning and proper clinical governance. However, the author is very implicit concerning the solution to the problem. Also, the article lacks factual, evidence-based support emphasizing the problems to which the author refers.
The article by Spigelman and Rendalls (2015) presents the results of a non-systematic literature review of the publications related to clinical governance in Australia. The authors integrate the findings from various literature sources to enlist all the issues and characteristic features related to the current state of clinical governance in the country. Thus, the article is aimed at generalizing the scope of issues characterizing Australian clinical governance to ensure informed decisions for further development by means of eliminating the difficulties.
The authors present a broad overview of the manifestations of clinical governance across different territories and types of care. A particular strength of the conducted research is the inclusion of the interviews with key stakeholders who provide accurate first-hand information on the real problems. Given the complexity of the healthcare jurisdiction system and the complexity of Australian demographics and geography, the implementation of clinical governance is challenging. Such an imbalance in jurisdictions’ responsibilities and distribution of responsibilities for care provision induces financial imbalance and higher cost of health care services (Spigelman & Rendalls, 2015). The array of identified problematic issues includes demographic and geographic variations that cause fragmentation in healthcare delivery, as well as management and the overall quality of care.
In summation, the article is strong research that provides a validated and well-articulated list of current issues that Australian clinical governance faces. However, despite the overview of the problematic issues, the guidance for improvement is very theoretical. Indeed, the suggestion for improvement of the functionality of clinical governance is articulated in the form of recommendations for the direction of improvement without practical solutions. Nonetheless, the work done by the researchers is a valuable basis for further search for the solution and development of practical steps toward the improvement of clinical governance.
Colin‐Thome, D. (2013). Development opportunities in the “new” NHS for personal, population and system care. Clinical Governance: An International Journal, 18(2), 6–17.
Spigelman, A. D., & Rendalls, S. (2015). Clinical governance in Australia. Clinical Governance: An International Journal, 20(2), 56–73.