A new National Model for Clinical Governance (national model) will support public and private hospitals to deliver better outcomes for patients amid mounting pressures on the health system. 

The Australian Commission on Safety and Quality in Health Care developed the national model to provide contemporary, best practice governance guidance for acute health services including day hospitals – supporting them to build the organisational culture, systems and structures to enable members of the workforce to deliver high-quality care, every day.

The national model represents a significant change in how clinical governance is understood, led and embedded in health services. 

It shifts the main focus from complying with accreditation requirements to building the culture of the organisation to one in which delivery of high-quality care is the core focus of everyone in a health service, every day. The guidance emphasises the importance of workforce wellbeing, clinician engagement, and the health of Aboriginal and Torres Strait Islander peoples.

Recognising that leadership is required to drive system-wide change, the national model aims to elevate clinical governance to the highest level of organisational leadership and oversight. The model reflects contemporary expectations of boards and executives in leading for high-quality care – defined by the Commission as care that is person-centred, safe, effective, accessible and integrated, and provided in a way that is equitable, efficient and sustainable.

At the Health Ministers’ Meeting on 1 May, all Australian Health Ministers urged public and private hospitals to implement the national model as part of national efforts to strengthen the safety and accountability of health care.

Commission CEO Conjoint Professor Anne Duggan said the national model positions Australia at the forefront globally on clinical governance, which is central to providing the best possible outcomes for patients – and ultimately reducing the risk of harm from adverse events. 

“Australia needs a unified national approach to clinical governance to steer the health system towards providing high-quality care in the face of evolving challenges,” she said. 

“The system is under continued pressure from workforce shortages, growing demand for health care, the need for environmentally sustainable care, changing patterns of disease, and constrained resources.

“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 ensure that high-quality care for patients remains the central focus.

“The states and territories have all called for national leadership on clinical governance.” 

Professor Duggan said health services that implement the national model will be primed to meet current challenges, with a framework to harness opportunities and manage the risks of new models of care and technologies, such as artificial intelligence.

“I urge health service boards, executives and clinical leaders to use the national model to reposition and streamline their organisation’s clinical governance system, shifting the focus from compliance to supporting managers and the workforce to deliver high-quality patient care every day.” 

Commission Chair Professor Christine Kilpatrick AO said every board member of a health service has responsibility for clinical governance, along with their other governance responsibilities. 

“When board members, executives and clinical leaders champion clinical governance as fundamental to achieving high-quality care, it sets the tone for the rest of the organisation,” Professor Kilpatrick said.

“The new model provides consistency and practical guidance on clinical governance for health leaders to set direction, build organisational culture and develop systems oriented to achieve high-quality care.”

The national model incorporates the latest evidence and was developed through rigorous consultation with the health sector. The Commission synthesised best practice corporate governance guidance and applied it to healthcare settings.

Effective implementation of the national model will strengthen health services’ clinical governance arrangements and position them to better address the requirements of the National Safety and Quality Health Service (NSQHS) Standards. 

The six foundations of clinical governance described in the national model will form the structure of the clinical governance standard in the next NSQHS Standards (third edition). All hospitals and day procedure services in Australia are required to maintain accreditation to the NSQHS Standards.

The national model is designed for all types of acute healthcare delivery, including face-to-face and virtual care, and applies to different types of hospitals and locations, including in rural and remote Australia. A practical guide to implementation and other resources will further support health services to improve their clinical governance arrangements. 

Download the national model