How to use this handbook

This is a tool to support the development of good practice, rather than a set of additional requirements for you to meet.

Embedding the four principles will help you to deliver the clinical governance arrangements, processes and outcomes necessary to support revalidation.

A full text description for this diagram is on page, marked as "Clinical governance principles - text alternative"

For each principle, we’ve described how to achieve it in practice. You can use these descriptions to help you to evaluate where you are meeting the outcomes and identify ways you can improve.

Responsibility for, and the delivery of clinical governance for doctors, AAs and PAs varies across the four countries of the UK, across sectors, between the professions and between different organisations. It is also dependent on whether an organisation acts at a national or local level. You should consider the handbook within the context of your organisation and it should also be used in conjunction with other relevant clinical governance guidance.

There is no specific requirement to report against the handbook. However, you may find it useful to record how it has been used in practice, when preparing for future inspection and internal audit work. Our Outreach team may reference this handbook in their regular discussions with healthcare providers, to support ROs with organisational clinical governance arrangements, and to help us to understand how local clinical governance processes supporting revalidation are working.

Specific governance considerations for Physician Associates and Anaesthesia Associates

All the principles in this guidance apply equally to doctors, anaesthesia associates (AAs) and physician associates (PAs).

In addition, organisations that employ AAs and PAs should ensure their governance arrangements take account of the fact that these professionals are trained and registered on the basis that they will always work under supervision.

We recommend that organisations identify an individual at Board level who is responsible for AAs and PAs, and that local processes are established governing how these professionals are deployed and supervised. The aim of such processes should be to ensure high quality, safe care, and to support effective multi-disciplinary working.