MOD006220 Policy Practice and
Governance
Element 010
Your next patient is an 84-year-old female patient
who has presented to A&E having suffered a fall.
You suspect a fractured neck of femur, and she
appears delirious.
How policy and governance impact patient
care
SID: 2215756
Word count: 3000
,SID: 2215756
MOD006220 Policy Practice and Governance
Introduction
Clinical governance advances healthcare in a direction that welcomes universal
adherence to regulatory and legal framework to optimise treatment strategies and
provide high-quality care for all. To truly improve the functionality of the National
Health Service (NHS), feedback from service users is essential to drive the
development of research and evidence-based methods to shape policies that better
prioritise the rights and best interests of patients. Above all, the inclusion of
principles outlined in the NHS constitution and medical ethics underpin the
motivations for providing better care, and portrays the NHS as an organisation that
views good clinical practice as an opportunity to strive for excellence.
The importance of policy in the NHS
Policies outline approved procedures and protocols that aim to provide the best
standard of care for all (Kruk et al., 2018). Specifically, adherence to policy helps
trusts stand up to scrutiny, but cannot protect trusts from being scrutinised. However,
it can ensure indemnity of an individual or service where adherence to policy would
jeopardise outcomes or not reflect the patient’s wishes. Their development also
furthers the NHS’ commitment to quality improvement and consistency in care
between trusts, forming the basis of clinical governance. This differs from legislation
that incorporates statutory and common law, and guides the creation of policy which
both help clinicians to operate within the limits of the legal system (Martin, 2008).
Governance consists of seven pillars, outlined in Figure 1. To fully integrate these
areas into practice, the creation of new agencies such as the National Institute for
Clinical Excellence (NICE) are necessary to monitor and set the standards for how
clinical scenarios are approached and managed (Price et al., 2020). Although clinical
governance aims to provide a positive and high-quality experience that inspires
confidence in professional standards within the NHS, a cross-sectional study from
Graham, Alderson and Stokes (2015) stresses that primary conflicts of interest
(patient wellbeing) are commonly influenced by secondary interests (financial
benefits such as payments from product manufacturers) and are not always
disclosed by committee members. Controversially, this was seen not only in NICE
1
, SID: 2215756
MOD006220 Policy Practice and Governance
but was found to directly influence policy development worldwide (George, Vesely
and Woolf, 2014).
Figure 1. The seven pillars of governance. These pillars shape policy, aiming for better standards
and equity in the services that the NHS provides for its patients (figure produced using information
from the Department of Health, 2022).
Similarly, evidence from one of the first reviews of governance by Onion (2000)
negatively reflects on the uncertainty of clinicians in its early stages, as governance
was seen to criticise, rather than facilitate clinical decision-making. It should instead
support and guide clinical judgement, that can still be applied where policies and
guidelines are too rigid to account for every preference and idiosyncrasy involved in
patient care. Other advantages include its impact that extends beyond the
relationship between patient and clinician, and its relevance to a wide array of
2
Governance
Element 010
Your next patient is an 84-year-old female patient
who has presented to A&E having suffered a fall.
You suspect a fractured neck of femur, and she
appears delirious.
How policy and governance impact patient
care
SID: 2215756
Word count: 3000
,SID: 2215756
MOD006220 Policy Practice and Governance
Introduction
Clinical governance advances healthcare in a direction that welcomes universal
adherence to regulatory and legal framework to optimise treatment strategies and
provide high-quality care for all. To truly improve the functionality of the National
Health Service (NHS), feedback from service users is essential to drive the
development of research and evidence-based methods to shape policies that better
prioritise the rights and best interests of patients. Above all, the inclusion of
principles outlined in the NHS constitution and medical ethics underpin the
motivations for providing better care, and portrays the NHS as an organisation that
views good clinical practice as an opportunity to strive for excellence.
The importance of policy in the NHS
Policies outline approved procedures and protocols that aim to provide the best
standard of care for all (Kruk et al., 2018). Specifically, adherence to policy helps
trusts stand up to scrutiny, but cannot protect trusts from being scrutinised. However,
it can ensure indemnity of an individual or service where adherence to policy would
jeopardise outcomes or not reflect the patient’s wishes. Their development also
furthers the NHS’ commitment to quality improvement and consistency in care
between trusts, forming the basis of clinical governance. This differs from legislation
that incorporates statutory and common law, and guides the creation of policy which
both help clinicians to operate within the limits of the legal system (Martin, 2008).
Governance consists of seven pillars, outlined in Figure 1. To fully integrate these
areas into practice, the creation of new agencies such as the National Institute for
Clinical Excellence (NICE) are necessary to monitor and set the standards for how
clinical scenarios are approached and managed (Price et al., 2020). Although clinical
governance aims to provide a positive and high-quality experience that inspires
confidence in professional standards within the NHS, a cross-sectional study from
Graham, Alderson and Stokes (2015) stresses that primary conflicts of interest
(patient wellbeing) are commonly influenced by secondary interests (financial
benefits such as payments from product manufacturers) and are not always
disclosed by committee members. Controversially, this was seen not only in NICE
1
, SID: 2215756
MOD006220 Policy Practice and Governance
but was found to directly influence policy development worldwide (George, Vesely
and Woolf, 2014).
Figure 1. The seven pillars of governance. These pillars shape policy, aiming for better standards
and equity in the services that the NHS provides for its patients (figure produced using information
from the Department of Health, 2022).
Similarly, evidence from one of the first reviews of governance by Onion (2000)
negatively reflects on the uncertainty of clinicians in its early stages, as governance
was seen to criticise, rather than facilitate clinical decision-making. It should instead
support and guide clinical judgement, that can still be applied where policies and
guidelines are too rigid to account for every preference and idiosyncrasy involved in
patient care. Other advantages include its impact that extends beyond the
relationship between patient and clinician, and its relevance to a wide array of
2
