The art of governance - RCPE conference

Collaboration, diversity and candour come to the fore at the Royal College of Physicians of Edinburgh’s first ever governance conference

Tuesday 14th May 2019

A call to arms to address governance across healthcare in Scotland was zealously answered at the Royal College of Physicians of Edinburgh’s inaugural quality governance conference last week.

Held at the Royal College’s (RCPE) quarters in Scotland’s capital, a wealth of experience in healthcare and governance from across the country and further afield was brought together for enlightening and inspiring talks and workshops.

“The time is now right – more than it has been for years – to look at our governance systems” - Professor Bell

Quality governance – a call to arms, published by the College last year, highlighted the establishment of the quality governance collaborative programme – an initiative looking to bring together multi-professional groups to highlight issues and improve the practice of quality governance.

Financial restraints, an ageing population and the need for change as part of the integration of health and social care services; the pressures on our health service are well documented.

Combine these with an acceptance of the commonalities that can be seen in reports on previous serious failings in healthcare settings across the UK, and we find ourselves in a situation where “the time is now right – more than it had been for years – to look at our governance system”, according to RCPE president, Professor Derek Bell.

“Learning cannot be left to chance encounters” – Susanna Stanford

It was patient turned collaboration and patient safety advocate, Susanna Stanford, who delivered a talk to the conference that epitomised the importance of good communication and governance.

Adamant that “learning shouldn’t be left to chance encounters”, it wasn’t long after her experience in hospital some eight years ago, that Ms Stanford discovered there was no established route for patients to give constructive feedback to clinicians.

A retelling of her experience of a spinal anaesthetic failure served as a stark reminder that when good governance fosters collaboration and communication between health professionals and patients, such traumatic events as those experienced by Susanna can be more easily avoided and at the very least, learned from when they do happen.

“You don’t need stakeholders, you need partners” – Paul Gray

The question of how to include already under pressure clinicians and patients on health boards to better inform governance in healthcare is an important one.

Former chief executive of the NHS in Scotland, Paul Gray, told attendees that “you don’t need stakeholders, you need partners when you are trying to do something as hard as achieving good governance”.

Equality is essential, he explained, when trying to diversify the make-up of Scotland’s boards and encourage those with front-line experience in Scotland’s healthcare settings to speak up.

The RCPE’s own quality governance collaborative fellowship programme is looking for patients, clinicians, managers and other health and social care professionals to join the second programme cohort later this year.

The programme’s emphasis on equipping a more diverse range of professionals and patients with the skills and knowledge to engage in governance and adopt leadership roles goes some way to meeting the need for more diverse recruitment emphasised by the current chair of NHS Greater Glasgow & Clyde, John Brown, during his presentation.


The ‘major part now played by data’ in healthcare is not one that can be ignored. RCPE president, Professor Derek Bell, encouraged action to achieve good data governance, and avoid Scotland’s health service remaining ‘information poor’ despite becoming increasingly ‘data rich’.

Concerns about data handling and garnering public trust should be assuaged by a concerted effort, guided by a golden thread of patient safety, to use the data we gather to improve the nation’s health.


A final observation from Paul Gray reminded delegates that investment now in governance will more than make up for itself by helping Scotland’s health service to avoid the mistakes of the past and enable it to look forward to a well governed and integrated future.