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“Learning through doing” and sharing the lessons across the NHS is an important aspect of the strategy to support the introduction of clinical governance. The CGST Web site is being developed as a national clinical governance resource. It will provide access to articles, papers and copies of presentations by members of the support team. A key part of the resource will be a collection of case studies to illustrate “Clinical Governance in Action” and show what has been achieved.

The NHS Clinical Governance Support Team (NCGST) is working with multidisciplinary teams as they begin the cultural shift in their sponsoring organisations towards the development of excellence in health care provision. Describes show how delegate teams move from an awareness of the problems, through gaining a commitment and agreement to change, to implementation of new ways of working.

The necessity for effective multidisciplinary team working within increasingly complex health and social care environments has been emphasised in The NHS Plan. Good teamwork makes a critical contribution to effectiveness and innovation in health‐care delivery and it is through such teams that the agenda of quality improvement through clinical governance can be delivered at local level. The NHS Clinical Governance Support Team’s Team Resource Management Programme supports individuals who work directly with poorly performing NHS teams. A case study example illustrates how a team coach has used her experiences on the Programme to facilitate effective change in a “troubled” team in her health‐care organisation.

To hammer home that clinical governance is the defining heart and inspiration of quality in the NHS and to expand on its implementation by all concerned.

Lists the ideal aspects and attributes of clinical governance.

Finds that clinical governance is a sine qua non and mandatory lever for achieving quality in the NHS and that whatever changes are necessary must be fully carried out.

Arguably, coming as it does from the top of the hierarchy, this posits the most soul‐searching advocacy of clinical governance's importance for the NHS so far presented.

To provide an overview of the change to NHS Clinical Governance Support Team's Board Development Programme.

The background to the programme, the methods adopted by the Board Team and lessons learned are outlined. Commitment and active support at Board and senior levels are known to be essential for organisational change and, in order to help translate aims into strategic priorities and to implement these into improved services, the Clinical Governance Board Support Team was formed in 2000 as part of the overall NHS Clinical Governance Support Team (CGST). Its members provide advice and support to NHS personnel who are involved in improvements to health care services.

The team worked initially with Boards of acute NHS Trusts and later with Primary Care, Ambulance and Mental Health Trusts. Among the lessons learned from their own work and the increasing body of research‐based evidence is the importance of the leadership role of the Board in fostering a positive culture of change, enthusing and empowering staff. Other factors are the effectiveness of communication with external organisations, scrutiny of all points of contact with users of the services and involvement of users – patients and carers – at all stages. The Team evolved during the programme, strengthening its clinical base and introducing patients and carers as associates. In order to meet demand and increase capacity of the Team, learning materials have been developed and these and their experiences widely disseminated. An example of success is demonstrated by the progress made by a pilot cohort of Primary Care Trusts.

This review summarises the aims, objectives and progress of the work of the Board Development Programme.

National Health Service trust boards are constantly challenged to achieve a balance between their resources and meeting the needs of the communities they serve. In addition, the scientific, technological, political and economic factors, which influence health and social care, are driving change more rapidly than ever before in the Health Service. As part of its function to support NHS organisations with the implementation of clinical governance, the NHS Clinical Governance Support Team (CGST) has developed a strategic development programme for trust boards. The aim of the programme is to develop the board’s capability to meet its responsibilities for governance and the delivery of safe, high quality patient care.

To report progress made by the National Clinical Governance Support Team's (CGST) Programme for Stroke between 2001 and 2004 and its effects on service provision.

The effectiveness of the Stroke Programme on services was assessed by comparing changes in services in Trusts which had undergone the process with those in a control group.

Using the Review, Agree, Implement, Demonstrate (RAID) model, the Stroke Programme led to benefits which include greater participation by patients and carers in treatment programmes and in development of services. Quantitative assessment of the extent of change in stroke services showed a significantly greater change in stroke unit provision, staffing levels and new funding in those sites which had attended the Stroke Programme.

The review provides an overview of recent developments in stroke services in the UK and describes the benefits of intervention by the Clinical Governance Programme.

To provide an overview of the learning from four practical programmes that explore different aspects of patient participation in healthcare provision.

To describe the origin and rationale for each project or programme, and to summarise the learning from it.

At a variety of levels, involving patients in the design of care services can provide new insights, and leads to more patient‐focused and locally appropriate solutions. Engaging patients appropriately is not a trivial exercise, and those that are engaged need appropriate support, but the resulting solution is often more widely applicable than is first anticipated and can be cost‐neutral.

The active participation of patients in the design and provision of care is a widely voiced public and professional aspiration, but is genuinely realised only rarely. The paper describes the principles, benefits and learning common to four practical expressions of that aspiration.

Purpose – To report on how service changes can be accelerated by working with large groups that represent all parts of a complete healthcare service or care pathway, during specific events, and using well‐defined facilitation techniques. Design/methodology/approach – Case examples are cited from the Clinical Governance Support Team's “protected time” programme and subsequent work, and specific quotes and examples from large group events are used to describe the potential impact of the approach. Findings – Established group facilitation techniques can be adapted for use in the context of a large group representative of a whole clinical system or pathway, to accelerate service improvement. Originality/value – The paper reports on the practical findings from Clinical Governance Support Team group facilitators working on large group events from a number of UK NHS Trusts.

Effective appraisal is one of the key underpinning systems to allow the practical implementation of clinical governance. Between March and July 2002, over 800 GPs have attended the national GP “Training the Appraisers” Programme, funded by the Department of Health, and run by the NHS Clinical Governance Support Team (CGST) in partnership with Edgecumbe Consulting Ltd. The one day programme, which includes practical “real life” appraisal sessions for GPs, is well on the way to meeting its remit of training 900 GP appraisers (an average of three appraisers per PCT) in 2002. Once they have completed the course, trained appraisers can begin the process of conducting the first round of appraisals in their local primary care organisations. The GP Appraisal Programme recognises the potential of an effective system of appraisal to develop over time, so that patients can be confident that their family doctor is supported in taking regular, structured steps to ensure they are identifying and fulfilling their professional development needs and thereby enhancing the delivery of high quality care.