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Surveys in the UK and USA show that error in health care is unacceptably high. It is also known, however, that considerable under‐reporting of error takes place and we need therefore to begin to understand why people fail to report so that we can introduce systems and develop cultures and systems which make this easier. Although this has been considered hypothetically, what happens in real situations and what the outcomes are for those individuals actually reporting has not been studied. This study is built on an earlier pilot of 228 doctors that considered the experiences and attitudes of a range of nurses and doctors to reporting their concerns. It includes those who went ahead and those who did not, as well as the attitudes of other staff with no experiences of wanting to report, and the types of event that were more likely to lead to reporting.

This article has been withdrawn as it was published elsewhere and accidentally duplicated. The original article can be seen here: 10.1108/14664109910315569. When citing the article, please cite: Jenny Firth-Cozens, (1999), “Clinical governance development needs in health service staff”, British Journal of Clinical Governance, Vol. 4 Iss: 4, pp. 128 - 13.

More GPs are needed, but there are concerns about retaining the existing workforce quite apart from recruiting new doctors. This survey of GP principals in the Northern deanery aged over 45, identified factors potentially encouraging them to take early retirement (before 60) or to work on beyond 60. Over a third of those with retirement plans intended to retire early. Perceived undesirable changes in the NHS and workload were the main factors influencing intentions to retire. Reducing hours and administrative duties, and improving managerial support were factors that may encourage later retirement. Financial incentives in the form of increased pensions were most attractive to those already planning later retirement. A total of 35 per cent scored above threshold for significant psychological distress, and the higher psychological distress the earlier GPs wanted to retire. Interventions encouraging later retirement should be targeted at reducing workload and administration. Interventions to reduce stress could also encourage later retirement.

This paper reports on a study to ascertain the development needs in terms of clinical governance of 220 health service staff across all the key professions from primary and secondary care, including chief executives and clinical governance leads. Interviews suggested that the development of clinical governance was progressing through the structures created by the leads, and that there was considerable goodwill shown towards it in most of the interviews conducted. Of the participants 69 per cent had heard of clinical governance, though detailed knowledge was rare. The author suggests that development overall needs to be carried out using a multi‐disciplinary and multi‐agency approach where possible, perhaps using pathways of care. It needs also to take account of the expressed fears from medical staff of discussing their care in a multi‐disciplinary setting, and of the two potential conflicting themes that are apparent to chief executives of change towards no‐blame cultures, while encouraging accountability and the recognition of risk.