This chapter focuses on the evolving and volatile UK National Health Service (NHS) regulatory and governance frameworks, and considers their impact upon healthcare organization and clinical practice. It reviews the inquiry culture that has influenced government policies on accountability and transparency in health care delivery, and critically assesses the central place accorded to clinical governance. The rise and function of audit and risk management, and the escalatory relationship between risk and regulation, are explored. The paradox that regulatory failures engender tighter controls which, in turn, generate further regulatory failures, is illustrated by reference to several case studies, including that of the death of ‘Baby Peter’, and its aftermath. The chapter concludes with a consideration of the limitations of regulatory control, highlighting the potential for constant review and reform to exacerbate gaps between policy and practice.
Keywords: regulatory frameworks; clinical governance; inquiry culture; audit; risk management; escalation
Chapter. 9266 words.
Subjects: Public Health and Epidemiology
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