The Importance of Governance as a private provider working with the NHS – Part One: Why is Governance Important?
By Lisa Townshend, Clinical Director, Pure Unity Health
This is the first in a three-part series from Lisa Townshend focusing on organisational governance in healthcare, particularly in the context of private providers collaborating with the NHS.
In this first part, Lisa establishes the foundational importance of governance in healthcare, focusing on the inseparable nature between clinical excellence and robust governance systems. This blog sets the stage for the following blogs in the series. Part two will address how governance has been embedded into our organisation, as well as the challenges associated with being an independent provider working with the NHS. Part three will focus on the importance of continuous improvement and staff development as part of effective governance.
As Clinical Director of Pure Unity Health Group, I am passionate about delivering exceptional patient care and, in my experience, have come to understand that clinical excellence depends on good governance.
In this first blog of a series of three, I will explain why good governance plays such an important role in service delivery.
What is Governance?
Governance refers to the framework of rules, practices, processes, and systems by which an organisation is directed and controlled.
Governance plays a critical role in ensuring safety, quality, efficiency, ethical conduct, and a culture of continuous improvement.
A robust governance structure serves as the backbone of an organisation, providing the foundation upon which trust, performance, and sustainability are built. It enables leadership to monitor performance, assess risks, and respond to challenges in a consistent and strategic manner.
Having effective policies and procedures in place safeguards our patients, staff, and stakeholders by minimising risks, preventing errors, and promoting accountability.
Why It Matters
- Ensures we deliver evidence-based, effective care.
- Enables early detection of adverse events, with structured incident reporting, investigation and monitoring that informs and drives improvement.
- Fosters psychological safety, creating an environment where clinical and non-clinical staff feel comfortable speaking up and reporting concerns. This is crucial in avoiding a toxic “culture of blame”, which is a known factor in diminished performance in healthcare settings.
The ability to evidence quality assurance is paramount when delivering services. Clinical governance provides the framework that underpins this assurance. The scope of clinical governance is broad, encompassing the activities that support the delivery of quality standard care.
The pillars of governance help us to break this down into clear, actionable sections:
Pillars of Clinical Governance
- Clinical Effectiveness & Research: Ensuring care is guided by evidence-based approaches aligned with guidelines (e.g. NICE), measuring outcomes, and adopting best practice.
- Risk Management & Patient Safety: Identifying and reporting incidents and near misses, maintaining a risk register, and conducting root cause analysis to reduce harm.
- Patient & Public Involvement: Engaging patients through feedback, surveys, and forums, to ensure that treatment decisions meet their needs and expectations.
- Clinical Audit & Monitoring: Reviewing care provided versus standards, implementing improvement plans, and reauditing to ensure progress.
- Staffing & Workforce Management: Recruiting and retaining competent clinicians, conducting performance appraisals, and fostering supportive team environments.
- Education & Training (CPD): Supporting lifelong learning via structured induction, regular appraisals, and opportunities such as courses, webinars, and conferences.
- Information & IT Management: Maintaining secure, accurate patient records, ensuring confidentiality, and utilising data for insight and quality improvement.
Pillars of Non-clinical Governance
Whilst clinical governance directly protects patient care, nonclinical governance ensures that the organisation operates with integrity, efficiency, compliance and trust.
Key pillars include:
- Finance & Compliance: Budget oversight, cost-effectiveness, and alignment of resources with clinical priorities.
- Workforce & HR: Workforce planning, staff wellbeing, and equity in recruitment and professional growth.
- Data Security & IT Infrastructure: Cybersecurity, GDPR compliance, and reliable IT systems underpin confidential patient care.
- Facilities & Health & Safety: Ensuring safe environments—equipment, premises, infection control, safeguarding.
- Leadership & Board Governance: Clear board-level accountability integrating clinical and corporate oversight.
- Strategic Planning & Stakeholder Engagement: Aligning vision, stakeholder input, and evidence-based decision-making.
Clinical and non-clinical governance must not operate in silos—they are deeply intertwined. A unified governance system requires them to function in tandem. Clinical governance ensures care is done right, while non-clinical governance ensures the conditions and systems are right to provide that care. Coordination between the two is essential for holistic, safe, and sustainable healthcare delivery.
From personal experience, I have seen the impact of this unified approach. Having this robust governance infrastructure allows us to adapt quickly to changing situations, maintain standards, and protect our patients and staff.
At the heart of all governance is our patients. When we get governance right, patients receive timely care, accurate information, and compassionate support from clinicians who are confident, competent, and supported.
In our organisation, we have tried to embed governance into daily practice and maintain a constant focus on improvement.
Final Thoughts
Being a Clinical Director is about being accountable. Governance is the tool that allows me to fulfil that accountability to our patients, staff and the wider system.
Excellence starts with good governance because it makes good care repeatable, safety predictable, and improvement possible.
In this blog, I’ve outlined the foundations of why good governance matters. In my next blog, I’ll explore how we’ve embedded governance within our organisation, and the unique challenges that come with being an independent provider working in partnership with the NHS.
Lisa Townshend, BSc Adult Nursing MSc Advanced Nursing Practice
Clinical Director, Pure Unity Health
Lisa is the Clinical Director at Pure Unity Health, bringing extensive experience in both clinical care and healthcare leadership. With a BSc in Adult Nursing and an MSc in Advanced Nursing Practice, Lisa began her career in an acute trust within the orthopaedic department, where she became one of the first Orthopaedic Nurse Practitioners—a role that supported the Consultants and their clinical teams to provide patient care.
Following the completion of her MSc, Lisa transitioned into Primary Care, where she combined clinical practice with senior management responsibilities. Her commitment to delivering high-quality, patient-centred care led to a strong interest in clinical governance, culminating in a two-year fellowship in patient safety. During this time, she focused on the implementation of the Patient Safety Incident Reporting Framework (PSIRF) within Primary Care, helping to embed a culture of learning and continuous improvement.
As Clinical Director, Lisa now leads the strategic direction of PUHG’s clinical services and governance processes ensuring that excellence in patient care remains at the heart of service delivery. She is passionate about integrating safety, innovation, and best practice across Pure Unity Health and the wider system.
