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Clinical Governance, the law and policy

We are all familiar with the term ‘clinical governance’ and its implications in our particular area and jurisdiction.  Most of us would agree that a systematic approach to maintaining and improving patient care within our system is a worthwhile objective.

02 Apr 2012

We are all familiar with the term ‘clinical governance’ and its implications in our particular area and jurisdiction.  Most of us would agree that a systematic approach to maintaining and improving patient care within our system is a worthwhile objective.

Of course, it requires practitioners and administrators to work together in a cooperative manner towards a common objective, and accept joint responsibility for matters that arise.

Effective clinical governance has the potential to improve patient care and provide better outcomes for staff, patients and administrators.  However, it has been noted that in jurisdictions such as New South Wales, very little in the way of new policy direction is being provided to assist in this area.

Particularly in the area of risk management and incident reporting, our members are reporting that administration has become onerous, with very little corresponding benefit.

In NSW, the Department of Health and Health Administration Regulation 2005 has defined ‘reportable incident’ as an incident with ‘serious’ or ‘major’ clinical consequences.

Serious clinical incidents (SAC1) are reported to the Department of Health.  Under the Health Administration Act a Root Cause Analysis (RCA) is required once an incident has been reported.  Less serious incidents are investigated at the local level and aggregated data is used to identify key issues.

We are seeing an increase in the amount of documentation, policies and procedures and a corresponding increase in the number of minor incident reports.  This has had an impact on service managers, with a sense that the expected standard is perfection.  This may have implications for practitioners across a range of legal areas, including duty of care, employment, and possibly even criminal law.  The issue of privilege relating to the information is not settled in most jurisdictions and is of some concern.

It has to be remembered, from a duty of care point of view, the standard required of practitioners is not ‘perfection’.  The exact definition varies among jurisdictions, but generally it is that of the ‘reasonable professional’.  For example, in NSW it is defined as acting in a manner widely accepted in Australia by peer professional opinion as competent professional practice. 1982 (NSW) s20M.

Civil Liability Act 2002 (NSW) s5O(1)


Published: 02 Apr 2012