VIEWPOINT: Clinical governance - the turn of continuous improvement?

An overview is provided of a model for clinical governance in the National Health Service that incorporates continuous improvement and innovation as a core theme. The core functions of clinical governance - and how these are related to established structures and roles within the modern NHS - are considered. A case study approach is used to describe the implementation of a theoretical model in a large teaching NHS Trust. A clinical governance cycle is described that comprises three functional domains: accountability, assurance, and innovation. For each domain there is a definable outcome and a key role. Critical success factors for implementation of the model are described.