Clinical Governance, Teamwork, and Health Psychology in Patient Care

This report provides a comprehensive analysis of clinical governance within the National Health Service (NHS), emphasizing its impact on patient care delivery. It explores the seven pillars of clinical governance, including risk management, clinical effectiveness, and patient involvement, highlighting their roles in ensuring high standards of care. The report also delves into the importance of teamwork in healthcare, discussing the stages of team development and the benefits of effective collaboration among healthcare professionals, such as improved patient outcomes and reduced medical errors. Furthermore, it examines the role of health psychology in patient care, emphasizing its contribution to understanding and addressing patients' psychological needs. The report concludes by underscoring the significance of clinical governance, teamwork, and health psychology in enhancing the quality and efficiency of healthcare services within the NHS framework.

Clinical Governance 3
questions to be answered

TABLE OF CONTENTS
QUESTION 1..................................................................................................................................3
Critical evaluation of Clinical Governance and its impact of delivery of patient’s care.............3
QUESTION 2..................................................................................................................................6
Importance of teamwork in the management of patient care......................................................6
QUESTION 3..................................................................................................................................8
Role played by health psychology in the delivery of patient care...............................................8
REFERENCES..............................................................................................................................10

QUESTION 1
Critical evaluation of Clinical Governance and its impact of delivery of patient’s care
Clinical Governance is basically a framework which is used by the NHS in order to
improve the quality of the services and also to safe guard the high standards of care. This is done
when an environment is created in which the excellence in the clinical care can be flourished.
The main role in clinical governance is played by the its seven pillars which are risk
management, clinical effectiveness, patient experience and involvement, resource effectiveness,
communication, learning effectiveness and the strategic effectiveness (Phillips and et.al., 2017).
This focuses on doing the right thing at the right time and also by the right person. The best
evidence must be applied to the patient’s problem according to the wish of the patient and that
also by trained and resourced team or individual. This is not enough for the clinical governance
but it also includes the organisation which is accountable for the staff actions, reduces the risks;
appraise the staff and also learning from the mistakes as well as good practices. The clinical
governance also adheres to the Healthcare standards (Saadati and et.al., 2018).
There are 7 pillars or areas into which clinical governance is divided. These 7 pillars helps in
quality assurance process for maintaining and improving standards of care for the patients along
with ensuring the full accountability of the existing system towards the patients.
Clinical Effectiveness and Research
Under this, NHS ensures that the best available evidence is used and thorough research is
done for providing the best outcomes for patients. The hospital settings and the practitioners
must work in the best interests of the patient and under this it is also ensured that the best care is
provided. The evidence based practices are carried out to decide the treatments and the decision-
making. Also, the standards and guidelines must be used for helping inform care such as NICE
guidelines, FGDP radiograph guidelines which all are backed by the evidence (Cleary and Duke,
2019). The new standards and guidelines must be implemented and developed.
Audit
This deals in the evaluation of the practice against the gold practice standard. This helps
in identifying the shortcomings and developing the methods for improving the outcomes. The
quality of care is thus improved which are provided. When the audit is carried out, it includes the
3

identification of concern or the interest, also researches about a standard which can be used to do
the comparison, collecting the data for the same, analysing the gathered data, evaluate the
shortcomings, adapt the methods which can be used for the change required and finally the
happening of re-audit takes place for closing all the gaps and the improvements.
Risk Management
Managing of the risks deals in the methods which can be used for understanding,
monitoring and minimizing the risks for the patients as well as the staff. This also involves
learning from the accidents that took place and leaning from the mistakes which took place in the
previous time. Due to this, the clinical governance in NHS helps in improving the quality of care
which is received by the patients. The clinical governance in NHS reports the incidents which are
missed and learns from them which helps in implementing the new methods by replacing the old
ones. Under the clinical governance, the NHS also follows the protocols such as hand washing,
IRR legislation and IRMER.
Education and Training
This pillar plays an important role as continual learning is important for the practitioners.
The NHS ensures that the practitioners remain up to date with the latest knowledge, skills and
research and integrating them in the Clinical Research and Effectiveness. NHS gives
opportunities to the practitioners to complete further training such as the diploma, certificates
and degrees. The system also provides work appraisals for assessing the areas of improvement
and the competency. Under the clinical governance, NHS also provides various chances to attend
courses, lectures and conferences for enhancing knowledge and skills.
Patient and Public Involvement
This is much to involve the patients in the clinical governance through which the quality
of services can be accessed from the patient’s perspective. This helps in addressing various
issues. NHS involves the patient and the public by taking the patient’s feedback through the
family and friends questionnaires, patient forums for discussing the matters of healthcare, patient
representatives on the hospital boards etc.
4

Information and IT
The clinical governance in NHS adheres to the data protection Act which means the data
remains protected and confidential for the patients. There is a proper management and storage of
the data of the patients along with using the audits properly.
Staff Management
This deals in managing the staff by ensuring that the appropriate and correct staffs are
employed for the correct jobs and designations. The NHS strives hard to resolve the staffing
issues such as the performance by encouraging the staff for participating actively in the
environment. The employers at NHS not only provide the open attitude but also the best working
conditions by managing the staff in the best possible ways (Ebrahimpour and et.al., 2018).
This is how, the clinical governance aims at managing the quality of the care provided having the
goal to establish and maintain the excellence standards for the health care. Clinical supervision
must not deal in blaming the staff for the things gone wrong by them. It must promote an ethos
of honesty and openness in the settings of the nursing. For this, the reflection must be used for
developing and enhancing the practice. This also helps in promoting the awareness of the
people’s strengths and weaknesses. This must be used for reviewing the practice as well as
making the changes whenever any problem is encountered.
On the other hand, it can also be stated that in order to implement the clinical governance there is
a need of creating the infrastructure. Furthermore, there is also a need for the views and support
of the stakeholders for ensuring that the policy of the clinical governance is well implemented.
Therefore, the executives of NHS consider the clinical governance as appropriate and proper set
of mechanisms for supporting the staff and encouraging the organisations for developing the new
and innovative approaches to improve the quality (Veenstra and et.al., 2017). NHS ensures that
not only the executives are set responsible but everyone in the hospital settings is responsible for
the same. The clinical governance can only be achieved when everyone in the system supports in
the practice setting. For taking everyone’s support, it is must to have a structured framework for
enabling the processes at the place. It is the responsibility of the executive board for
implementing the initiatives of the clinical governance across the different practice areas.
5

Hence, the clinical governance in NHS deals to address the quality issues by dealing with the
clinical risks, incidents and complaints, set the standards of practice, benchmarking the same,
improving the care and practice for the patients using the services, supports the staff and
promotes the lifelong learning. In order to seek its best possible results, the staff of NHS supports
and helps to maintain, monitor and develop their practice at all the levels whether it us
individual, team or organisation.
QUESTION 2
Importance of teamwork in the management of patient care
The effective teamwork impact positively not only for the patient but also for the
organisations and the healthcare settings. Its need is increasing day by day because of the
complexity in the care specialisation which is increasing and the enhanced co-morbidities. The
effective team helps in delivering exceptional care to the patients. In order to construct patient
centred and more effective healthcare delivery system, it is must to have an effective teamwork.
The healthcare which is based on the team is basically the provision of health services to the
families, individuals and the communities by two or more health providers who are able to work
collaboratively with the care givers and the patients. This can help in achieving and
accomplishing the shared goals in the settings for achieving the high quality and coordinated
care. The shared responsibility plays a major role along with the accountability but if the shared
responsibility occurs without the effective teamwork, it can lead to immediate risks for the
patients (Logan and Michael Malone, 2018).
This was also observed that lack of communication among the health care providers, caregivers
and the patients has forced the patients to take legal actions against the healthcare providers such
as medical errors etc. When the effective teams are formed in the healthcare settings, then this
can reduce the adverse events which are caused by the miscommunication and the
misunderstandings. This is seen that there is a need of integrating new technologies into the
management processes for which developing the effective teams is necessary.
In order to form an effective, coherent and strong team, the healthcare setting must ensure that
the team passes through the following stages of the Tuckman’s model:
6

Forming: At this stage, the team members are unclear and are not prepared to work together as a
team. This is why they are not ready to communicate and thus interact in an impersonal and
superficial manner.
Storming: This is the stage where conflicts take place between the team members because they
do not know each other can develop negative thoughts for each other. This is also the stage
where the team members are frustrated for not achieving the progress and the goals which are
supposed to be accomplished.
Norming: At this stage, the team members communicate openly and are ready to accept the
challenges and take the tasks at the hand. The teams accept the communication patterns and the
procedures due to which the best patterns are established.
Performing: The team here becomes supportive, collaborative, open and trusting, effective and
resourceful. Here, the team lays emphasis on achieving the goals of the team as well as the
organisation.
After formation of the teams, the members interact dynamically which leads to proper delivering
of the health care services to the patients leading to the effective teams (Ogbonnaya and et.al.,
2018).
These effective teams benefits the organisation as the time and the costs of hospitalisation is
reduced, the unexpected admissions are reduced, accessibility of the better services to the
patients increases. This also benefits the teams as the health care services are efficiently used, the
communication and the professional diversity is enhanced, the coordination of care is improved.
The satisfaction of the patients is enhanced, they accepts the treatment more effectively, the
health outcomes and the quality of care is improved along with minimizing the medical errors.
When the different physicians, nurse, healthcare professionals etc. are in a team then it is must
for them to clearly communicate and build the stronger relationships by exchanging information,
cooperating with each other, providing timely consent and integrating the medical records etc.
This helps in decreasing the stress of the patients which helps in gaining positive outcomes.
These also lead to less medical issues which are due to the burnout in nurses (Schmutz, Meier
7

and Manser, 2019). The nurses do not take the responsibility of the patient’s health but takes the
support of the teammates for making effective decisions. The various goals are achieved by the
effective teamwork such as enhancing the patient’s safety, improving the clinical performance,
cutting down medical errors, easing the patient concerns regarding the procedures and treatments
and raising the efficiency and lowering the costs of healthcare. In order to gain these benefits, the
leaders must be efficient for adapting to the different circumstances on the basis of the team,
needs of the healthcare organisation and the patient care goals. They must be flexible to help
their team members in a respectful manner.
QUESTION 3
Role played by health psychology in the delivery of patient care
Health psychology deals in the behavioural and the psychological processes in the illness,
health and healthcare. This impacts the illness and the physical health of the patients. This is
observed that the biomedical knowledge is much important to provide sound medical care but
this is not enough as neither the brainless nor the mindless can be tolerated in medicine. The
psychosocial sciences help in analysing the way in which the mind and the brain works along
with interacting for generating the abnormality and normality. The bio psychosocial model
evaluates that the illness and health are the product of combination of factors such as social
(family relationships, social support etc.), biological characteristics (genetic predisposition etc.)
and the psychological factors such as lifestyle, health beliefs and the stress. Among all these
factors, the major role is played by the psychological factors as by analysing this, the patients can
reduce the risks of developing the medical issues, reduce the costs of their healthcare and also
receives more effective treatment from the team in which the psychological health providers
plays the major role (Farber and et.al., 2017).
This is why, the demand for the psychologists is increasing day by day because they are properly
equipped with skills, training and knowledge for analysing the ways in which the body becomes
able to develop dysfunctions by making use of cognitive and behavioural processes. The major
area where the significance of psychology is appreciated in the healthcare delivery is the attitude
of those people who deliver the intervention to the patients (Wood and et.al., 2019). For
example, the alcohol awareness programmes can be effectively implemented in a group of
problem drinkers. The psychologists not only deal with the biomedical issues of the patient but
8

also focus on the behaviour, thinking and psychology of the patients which mainly impacts the
overall health. The cognitive behavioural therapy is the most prominent example which is
suggested by the psychologists to analyse the mental condition of the patient and to change the
behaviour of the same from negative to positive. This helps in improving the condition of the
patients especially suffering from the mental disorders like anxiety, dementia, hypertension,
depression etc. The doctors need to be much more confident about handling the negative
reactions of the patients in such therapies. Psychology is considered as the science of behaviour
which offers for enhancing the health promotion and preventing the diseases along with
addressing the health disparities. The psychology not only plays major role in assessing the
problems but also in treating the diseases in primary as well as other healthcare settings. It helps
in treating various diseases such as Alzheimer, Pediatric Cancer, Adult Cancer, Obesity, Ulcers
etc. The psychologists are considered as the health providers who play the clinical role in
specific areas and subspecialties (Castelnuovo, 2017). They assess, diagnose and treat the
psychological problems along with the behavioural dysfunctions which are developed from
mental and physical health. This also helps in promoting the healthy behaviour, preventing the
diseases and improving the quality of the patients life.
9

REFERENCES
Books and Journals
Castelnuovo, G., 2017. New and old adventures of clinical health psychology in the twenty-first
century: standing on the shoulders of giants. Frontiers in psychology. 8. p.1214.
Cleary, S. and Duke, M., 2019. Clinical governance breakdown: Australian cases of wilful
blindness and whistleblowing. Nursing ethics. 26(4). pp.1039-1049.
Ebrahimpour, H. and et.al., 2018. The Effect of Clinical Governance on the Nurses’
Performance. Journal of Health. 9(2). pp.172-181.
Farber, E.W. and et.al., 2017. Psychology in patient-centered medical homes: Reducing health
disparities and promoting health equity. American Psychologist. 72(1). p.28.
Logan, T.R. and Michael Malone, D., 2018. Nurses’ perceptions of teamwork and workplace
bullying. Journal of nursing management. 26(4). pp.411-419.
Ogbonnaya, C. and et.al., 2018. Perceived organizational support in health care: The importance
of teamwork and training for employee well-being and patient satisfaction. Group &
Organization Management. 43(3). pp.475-503.
Phillips, C. and et.al., 2017. Improving quality through clinical governance in primary health
care.
Saadati, M. and et.al., 2018. Accreditation in one teaching hospital: a phenomenology study
among Iranian nurses. International journal of health care quality assurance.
Schmutz, J.B., Meier, L.L. and Manser, T., 2019. How effective is teamwork really? The
relationship between teamwork and performance in healthcare teams: a systematic
review and meta-analysis. BMJ open. 9(9). p.e028280.
Veenstra, G.L. and et.al., 2017. Rethinking clinical governance: healthcare professionals’ views:
a Delphi study. BMJ open. 7(1).
Wood, L. and et.al., 2019. The role of psychology in a multidisciplinary psychiatric inpatient
setting: Perspective from the multidisciplinary team. Psychology and Psychotherapy:
Theory, Research and Practice. 92(4). pp.554-564.
10