dutyofeachHealthAuthority,PrimaryCareTrustandNHSTrusttoputandkeep
inplacearrangementsforthepurposeofmonitoringandimprovingthequalityof
health care which it provides to individuals.
Section 19 and Schedule 2 create a new Commission for Health Improvement
.CHI) with functions stated in section 20 .1):
`.a) the function of providing advice or information with respect to arrange-
mentsbyPrimaryCareTrustsorNHStrustsforthepurposeofmonitoringand
improving the quality of health care for which they have responsibility.
.b)thefunctionofconductingreviewsof,andmakingreportson,arrangements
by Primary Care Trusts or NHS trusts for the purpose of monitoring and
improving the quality of health care for which they have responsibility.
.c) the function of carrying out investigations into, and making reports on, the
management, provision or quality of health care for which Health Authorities,
Primary Care Trusts or NHS trusts have responsibility.
.d) the function of conducting reviews of, and making reports on, the man-
agement,provisionorqualityof,oraccesstooravailabilityof,particulartypesof
health care for which NHS bodies or service providers have responsibility.'CHI operates with another NHS body, The National Institute for Clinical Excel-
lence.NICE),whichhasbeenestablishedasaSpecialHealthAuthority,.National
InstituteforClinical Excellence.EstablishmentandConstitution) Order1999, SI
1999/220).
NICE's role [22] is to establish a coherent programme of activity to develop
guidanceonclinicalandcosteffectiveness.NICEhelpsensureuniformlyhighcare
standardsacrosstheNHS.Clinicalguidelinesareissuedonindividualtreatments,
productsandclinicalinterventions.Lifestyleadviceisalsotobegiven.Guidanceis
appraised and disseminated.
CHIlooksathowtheNICEguidanceisbeingimplementedacrosstheNHSand
it has used its powers to review, investigate and report on these matters, high-
lighting failures. NHS health bodies have to establish arrangements which show
how these initiatives are being implemented. NICE, to date, has been very active
and a number of national guidelines have been issued.
CHIandNICEarecentralfeaturesoftheGovernment'shealthimprovementand
monitoring programme along with the concepts discussed earlier, clinical
governance,controlsassurance,clinicalriskmanagement,patientempowerment,
etc.TheyarealsocentraltotheefficientexecutionoftheNHSNationalPlan.Some
of these terms will be discussed further in later chapters.
5.3.2 Clinical governance, controls assurance an drisk management
Clinical governance provides a framework, `within which local organisations can
worktoimproveandassure thequalityofclinicalservicesforpatients' [23].Itis:
`A framework through which NHS organisations are accountable for
continuously improving the quality of their services and safeguarding high
standardsofcarebycreatinganenvironmentinwhichexcellenceinclinicalcare
will flourish.'The Policy Dimension: the Legal Environment of the New NHS 69