Clinical governance and continuing professional development

Some would argue that management and medicine, especially psychiatry, have a great deal in common. For a reasonable chance of success both require a high level of knowledge, skills in working with people and positive attitudes. Both also require knowledge and skills to be applied in complicated situations where there is no 'right' answer. Evidencebased practice is possible in management as well as in medicine, although the type of evidence used in management would rarely meet the specifications of the randomised double-blind placebo-controlled trial. It is even possible to apply evidence-based principles to policy-making, although there is as yet precious little evidence of this in health policy. Making the National Health Service (NHS) work better requires a great deal of clarity and honesty in understanding the problems that currently exist. Governance implies a duty to ensure quality and a system for achieving this. Continuing professional development implies a process of positive change for the individuals who deliver that quality service. Before going on to consider the relationships between clinical governance and CPD in more detail, we will consider some of the background in terms of management theory and the politics of recent problems in the NHS.