Almost a decade after the Government called for more clinical governance in the health system to help improve patient care and safety, researchers have found little has changed.

A new survey by the University of Otago found that there was an increase in health professionals’ understanding of clinical leadership.

However, there was a considerable decline in health professionals being involved in changing the health system to benefit patients.

There was also a decrease in practitioners that thought it was easy to speak up if they perceived a problem with patient care.

Professor Robin Gauld and Dr Simon Horsburgh from the University’s Centre for Health Systems and Technology compared their survey results to an earlier study, undertaken in 2012.

Gauld said the report was a wake-up call for both the government and the health sector.

“Although good progress was made between 2010 and 2012, this continued improvement has not been seen in the 2017 survey results.”

He said it was disappointing there had not been greater improvement in engagement with clinical governance over time.

“The decline in staff saying that it is easy to speak up when they perceive a patient care problem is a concern. This has occurred despite the work from central agencies and the organisations themselves. All consumers would want improvements in clinicians’ willingness to speak up.”

Health Quality & Safety Commission medical director Dr Iwona Stolarek said it was hoped boards and senior management would take note of the findings and increase their focus on the areas that have shown little or no improvement.

 “The development of strong clinical governance must continue to be a top priority for DHBs, and we will keep partnering with the sector to support improvement.”

Gauld said he supported the Commission’s calls for more support for clinical governance across the health sector and a clear commitment from DHBs.

“In times of fiscal constraint and increasing clinical workload, evidence shows that organisations with strong clinical governance continue to provide higher quality, safer, care.”

New Zealand’s focus on clinical governance began in 2009, following a report from a ministerial task group. Then Minister of Health, Tony Ryall, stated an expectation that all DHBs would work to implement recommendations centred around clinicians being involved in decision-making, to help improve the quality of clinical services and ultimately improve patient care.


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