Clinical governance is a framework that guides healthcare organisations in continuously improving service quality. The framework also safeguards high standards of care by creating an environment in which excellence in clinical care will flourish.

• Providing an opportunity to understand and develop the fundamental components required to facilitate the delivery of quality care.
• Developing a questioning, learning culture, excellent leadership and an ethos where staff are valued and supported as they form partnerships with patients.
• Demanding the re-examination of traditional roles and boundaries between health professionals, between doctors and their patients, and between managers and clinicians.

Furthermore, the World Health Organisation requires its member states to endeavour to:

• Pay the closest possible attention to patient safety.
• Establish science-based systems to improve patient safety.
• Develop and promote evidence-based policies, including global standards to improve patient care.
• Develop mechanisms through accreditation and other means.
• Recognise excellence in healthcare and patient safety.
• Encourage research into patient safety.

Clinical governance at Netcare

At Netcare, our clinical governance guidelines encourage an accountable, learning healthcare organisation. We take pride in providing world class, high quality patient care that is cost effective and accessible, and we do not tolerate less than best practice.

David Garvin, in the August 1993 Harvard Business Review, defines a learning organisation as “an organisation skilled at creating, acquiring and transferring knowledge, and at modifying its behavior to reflect new knowledge and insights.” Netcare is dedicated to growing and maintaining a learning organisation that embraces its successes, acknowledges its failures and applies these lessons to improving healthcare services to all patients.

Netcare’s clinical governance programme aims to:

• Promote best clinical practice;
• Provide scientific evidence of care through research and development;
• Ensure professional service is delivered at all times while continually improving quality;
• Ensure that our people are optimally and effectively utilised, trained and incentivised;
• Eliminate clinical risk; and
• Partner with physicians and healthcare service providers to enhance patient care.

Delivery of clinical governance includes the design and implementation of systems that take into account new approaches to leadership, strategic planning for quality, patient involvement, information and analysis, the management of staff and process management.

The four pillars of clinical governance

• Clinical effectiveness and clinical practice: Dr VL Faure 
• Clinical risk management: Annemie Greeff
• Patient experience: Jacques du Plessis
• Professional development, management and training: Shannon Nell

Medical Advisory Ethics Committee

The formation of the Medical Advisory Ethics Committee (MAEC) in 2005 was a historical first, not only for Netcare but for the whole private healthcare sector, in that doctors became involved on a strategic level to advise Netcare on clinical governance, ethical and professional practice matters related to hospital operations.

The committee consists of Netcare specialists elected by their fellow doctors to represent the views of the Netcare medical community. It also includes an external ethical expert from the academic sector and clinical governance representatives from Netcare management. The MAEC meets quarterly and members serve 3 year terms. Committee members are specialists specifically chosen for their expertise as advisers, negotiators and members of various regulatory, decision making and ethical bodies in the medical field.

The main functions of the MAEC are to:

• Advise on how to maintain the highest standards of quality care possible, in relation to international research and best clinical practice, to effectively implement the systems and concepts of clinical governance. 
• Monitor that clinical outcomes of quality care are measured and corrected, and clinical risks are investigated and minimised. 
• Advise on ethical issues related to patient care, patient information, patient confidentiality and record keeping. 
• Oversee the management of professional conduct and professional practice of doctors within Netcare facilities.
• Determine the continuing professional developmental needs of doctors and ensure that doctors utilising Netcare facilities are suitably qualified and registered. 
• Assist with developing cost effective care and alternative reimbursement models.

Structure of the MAEC

Profiles of MAEC members
The following table provides a brief profile of each of the doctors currently serving on the MAEC:

The Medical Advisory and Ethics Committee has investigated the process pertaining to organ transplants carried out in the Netcare Group and are of the view that the transplant protocols and procedures currently being implemented are robust and compliant with legal and ethical standards.

The first Medical Advisory and Ethics Committee was established in 2006 for a period of 3 years. The term of the current Medical Advisory and Ethics Committee commenced in September 2009. Accordingly, the committee was not in existence at the time of the alleged offences arising out of organ transplants performed at the Netcare St Augustines Hospital during the period of June 2001 to November 2003.

What is clinical governance? 
Clinical governance at Netcare 
Medical Advisory Ethics Committee