The evidence base for clinical governance.
OBJECTIVE
Clinical governance has been advanced as a mechanism for continuous quality improvement within the UK National Health Service (NHS). This study aimed to assess whether evidence exists to support this claim.


METHODS
A Medline search for evidence to link the introduction of clinical governance to improvements in the quality of health care was conducted.


RESULTS
Of the 335 papers retrieved initially, 114 were potentially relevant to the question, but only 10 attributed changes in quality to clinical governance directly. Of these, only three attempted to provide data to support the assertion.


CONCLUSIONS
No sound evidence currently exists to support the claim that clinical governance will increase service quality and moves towards its implementation must therefore be questioned.
Department of Anaesthesia, Southmead Hospital, Bristol, UK. mxtho@hotmail.com
Matt
M
Thomas
D019317:Evidence-Based Medicine; D006801:Humans; D008485:Medical Audit; D015397:Program Evaluation; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom