ArticleBMC health services research2008
Beyond the limits of clinical governance? The case of mental health in English primary care.
Article in BMC health services research, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review.Implementation science : IS · 2018Pooled it
- Governance and mental health: contributions for public policy approach.Revista de saude publica · 2017Pooled it
- A qualitative systematic review of studies using the normalization process theory to research implementation processes.Implementation science : IS · 2014Pooled it
- Nurturing an organizational context that supports team-based primary mental health care: A grounded theory study.PloS one · 2024Article
- Examining drivers of self-harm guideline implementation by general practitioners: A qualitative analysis using the theoretical domains framework.British journal of health psychology · 2022Article
- Establishing clinical governance model in primary health care: A systematic review.Journal of education and health promotion · 2021Review
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- Article
- Improving the normalization of complex interventions: part 1 - development of the NoMAD instrument for assessing implementation work based on normalization process theory (NPT).BMC medical research methodology · 2018Article
- Assessing the implementation processes of a large-scale, multi-year quality improvement initiative: survey of health care providers.BMC health services research · 2018Article
- Exploring drivers and challenges in implementation of health promotion in community mental health services: a qualitative multi-site case study using Normalization Process Theory.BMC health services research · 2018Article
- Healthcare professionals' views of the enhanced recovery after surgery programme: a qualitative investigation.BMC health services research · 2017Article
- Understanding clinician attitudes towards implementation of guided self-help cognitive behaviour therapy for those who hear distressing voices: using factor analysis to test normalisation process theory.BMC health services research · 2017Article
- Current situations and future directions for mental health system governance in Nepal: findings from a qualitative study.International journal of mental health systems · 2017Article
- Challenges in evaluating clinical governance systems in iran: a qualitative study.Iranian Red Crescent medical journal · 2014Article
- Feasibility evaluation of an interpersonal and social rhythm therapy group delivery model.Archives of psychiatric nursing · 2013Article
- Improving the normalization of complex interventions: measure development based on normalization process theory (NoMAD): study protocol.Implementation science : IS · 2013Article
- Collaboration between general practitioners (GPs) and mental healthcare professionals within the context of reforms in Quebec.Mental health in family medicine · 2012Article
- Implementing a stepped-care approach in primary care: results of a qualitative study.Implementation science : IS · 2012Article
- Innovation in mental health services: what are the key components of success?Implementation science : IS · 2011Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle research attention has been given to attempts to implement organisational initiatives to improve quality of care for mental health care, where there is a high level of indeterminacy and clinical judgements are often contestable. This paper explores recent efforts made at an organisational level in England to improve the quality of primary care for people with mental health problems through the new institutional processes of 'clinical governance'.
methodsFramework analysis, based on the Normalisation Process Model (NPM), of attempts over a five year period to develop clinical governance for primary mental health services in Primary Care Trusts (PCTs). The data come from a longitudinal qualitative multiple case-study approach in a purposive sample of 12 PCTs, chosen to reflect a maximum variety of organisational contexts for mental health care provision.
resultsThe constant change within the English NHS provided a difficult context in which to attempt to implement 'clinical governance' or, indeed, to reconstruct primary mental health care. In the absence of clear evidence or direct guidance about what 'primary mental health care' should be, and a lack of actors with the power or skills to set about realising it, the actors in 'clinical governance' had little shared knowledge or understanding of their role in improving the quality of mental health care. There was a lack of ownership of 'mental health' as an integral, normalised part of primary care.
conclusionDespite some achievements in regard to monitoring and standardisation of prescribing practice, mental health care in primary care seems to have so far largely eluded the gaze of 'clinical governance'. Clinical governance in English primary mental health care has not yet become normalised. We make some policy recommendations which we consider would assist in the process normalisation and suggest other contexts to which our findings might apply.
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