Clinical governance

Australia needs a unified national approach to clinical governance to steer the health system to provide high-quality care in the face of evolving challenges – workforce shortages, growing demand for health care, the need for environmentally sustainable care, changing patterns of disease, and constrained resources.

Data show that clinical governance remains a challenge for many health services. While many health services have been able to embed strong clinical governance in this changing environment, some have found it difficult to implement systems that engage the workforce and make a difference to the care that patients receive. 

All health ministers have urged acute health services to implement the national model. The Commission’s leadership in advancing clinical governance has been welcomed across the continuum of care and by all states and territories.

The national model is a short, simple, principles-based document that describes key actions and clarifies roles within health services to achieve high-quality care. It replaces the 2017 National Model Clinical Governance Framework.

The new 2026 model signals a strategic shift in how clinical governance is understood, led and embedded in all health services. The aim is to elevate clinical governance to the highest level of organisational leadership and oversight. 

Key changes are:

• Patient outcomes are at the centre – making high-quality patient care the end goal for everyone working in a health service.
• Clinical governance is repositioned – from being an end in itself to supporting managers and the workforce to deliver high-quality care. The national model provides the key principles and role clarity to achieve this.
• Organisational culture is a key focus – along with systems and structures to enable high-quality care.
• Accountability and workforce wellbeing are highlighted – as they directly impact patient care.
• The crucial role of boards and executives is emphasised – in governing and leading for high-quality care.
• Accountability for cultural safety is elevated to board level – to improve outcomes for Aboriginal and Torres Strait Islander patients.

The national model is for public and private health services in the acute sector, including day hospitals. 

It encompasses all types of healthcare delivery, including face-to-face and virtual, and can be applied to different settings including in rural and remote Australia.

The model is aimed at boards and executives who have a central role in providing the right culture, structures, support and leadership to deliver high-quality care. Where an organisation does not have a board and executive, these roles fall to the key decision-maker and accountable person or group in the organisation.

At the same time, the national model is designed to be understood by all the workforce, as everyone has a role in providing or supporting the delivery of high-quality care.

In developing this model, the Commission reviewed the latest evidence and consulted with leaders and clinicians across Australia to understand how clinical governance is understood and applied, gaps in capability and delivery, and what high-performing organisations do differently. The Commission reviewed and synthesised best practice corporate governance guidance and applied it to healthcare settings.

We worked closely with state and territory health departments, peak medical and nursing bodies, high-performing health services and individual clinicians to design a model that meets the needs of diverse services and settings. 

We then consulted rigorously across the health system to test and refine the model.

The national model aims to support health services to give patients the care they need and expect. 

Partnering with consumers in clinical governance – and with patients in their own care – is critical to achieving high-quality care. A key focus of the national model is creating or strengthening the systems and organisational culture needed to hear and act on patient and consumer voices.

The model emphasises the crucial role of cultural safety in improving health outcomes for Aboriginal and Torres Strait Islander people.

It commits boards and executives to respond to the unique needs of Aboriginal and Torres Strait Islander patients as core business.

When done well, clinical governance creates the right systems and environment to support clinicians to provide the best possible care for patients. 

The national model recognises that clinical leadership is central to the delivery of high-quality care and that clinical leaders have a responsibility to improve clinical governance systems across an organisation.

Boards and executives can use the national model to reposition and streamline their organisation’s clinical governance system, shifting the main focus from compliance to supporting managers and the workforce to deliver high-quality care.

Quality and Safety Managers can use the model to review their organisation’s clinical governance arrangements, identify what their organisation needs to achieve consistently high-quality care, develop an implementation plan, and monitor delivery of high-quality care.

Clinicians can use the model to support and reinforce their dual roles as healthcare professionals and stewards of system improvement.

State and territory health departments and private hospital groups can use the model to inform clinical governance systems and to shape detailed guidance for health services.

The model stresses that good corporate governance includes good clinical governance, and high-quality care is a strategic and organisational priority for all health service board members and executives.

While the six foundations of clinical governance in the national model were developed for acute health services, the principles are applicable across the broader health system. 

In future, the Commission will consider how the foundations of clinical governance can apply to other sectors of the health system.