New national direction for clinical governance highlights crucial role of boards

What is the national model about?

The national model is a short, simple, principles-based document aimed primarily at health service boards and executives. It is designed for public and private health services in the acute sector, including day hospitals, and can also be adapted for organisations across human service sectors.

It identifies six foundations of clinical governance and provides practical guidance for boards to set organisational direction to achieve high-quality care. It provides key examples of what good practice looks like, along with warning signs of poor practice.

The aim is to reshape Australia’s approach to clinical governance by shifting the main focus from complying with accreditation requirements to building an organisational culture and systems that prioritise delivering high-quality care every day.

Developed through rigorous consultation with health system leaders, the national model:

• defines and identifies high-quality care as the purpose of effective clinical governance
• reflects contemporary expectations of boards and executives to lead and be accountable for high-quality care, elevating care quality to the same level as financial and legal issues at a board and executive level
• recognises that clinical leaders have a responsibility to improve clinical governance systems across an organisation
• positions workforce wellbeing, cultural safety and consumer partnerships as core governance activities.

The national model is accompanied by a practical guide to implementation that supports health services to compare the model’s principles with their current clinical governance system, as well as develop and roll out an implementation plan to address gaps and monitor progress.

What does it mean for board members or directors?

There are compelling reasons for health service board members or directors to take the national model seriously.

In their joint meeting on 1 May 2026, all health ministers urged acute health services to implement the national model as soon as possible. Its principles and structure will be reflected in the next edition of the National Safety and Quality Health Service (NSQHS) Standards, anticipated to be released in 2028. All hospitals and day hospitals in Australia are required to maintain accreditation to the NSQHS Standards.

Michael Gorton AM FAICD, a lawyer and Board Chair of Monash Health, Wellways Australia and the Holmesglen Institute, says fiduciary responsibility for clinical governance lies with every health service board member, including those from non-clinical backgrounds.

‘It’s not enough to rely on the safety and quality committee. The national model reinforces the point that good clinical governance is as important for the board as financial, legal and workforce matters,’ Mr Gorton says. ‘Corporate governance and clinical governance are entwined in a health service, because our core business is providing high-quality care.’

The national model states that boards should incorporate high-quality care as a strategic and operational priority. They should prioritise high-quality care as a key performance indicator, in conjunction with corporate and financial priorities, and reflect high-quality care in the organisation’s risk appetite, executive priorities, workforce planning, culture and business plans.

An important advantage of the national model is that it clarifies that the purpose of clinical governance is central to a health service providing consistently high-quality care – defined as care that is person-centred, safe, effective, accessible and integrated, provided in a way that is equitable, efficient and sustainable.

Clinical governance expert Dr Cathy Balding says the national model provides a powerful north star for the board to understand whether their organisation’s clinical governance system is achieving its purpose.

‘Just looking at data with no purpose and no clear understanding of what you’re trying to achieve means you’re not leading and driving your organisation towards high-quality care; you’re just treading water,’ says Dr Balding GAICD, Director of Qualityworks and a director of RSL LifeCare NSW.

‘With the national model, you can start to ask questions of your reporting to help you understand whether your organisation is achieving its purpose – providing high-quality care.’

Is the national model relevant for boards in other sectors?

While the national model is for hospital boards, Dr Balding says its principles are relevant and useful for the boards of any human services organisation, such as those in the aged care, disability or community services sectors.

‘The national model is principles based so it can be adapted to support all human services in their fiduciary duty to act in the best interest of the organisation, which includes providing the best possible care and environment for both patients, consumers and staff,’ she says.

Importantly, Dr Balding says the national model emphasises that human services boards need to deeply understand the experiences and outcomes of people receiving care.

‘It is sometimes difficult for boards to come to terms with this responsibility, particularly if there are few or no clinical or care experts on the board,’ Dr Balding says. ‘But you have to have a deeper understanding of what's happening at the point of care than you do for other aspects of governance, such as finances.’

Building a safety culture

Professor Judy Searle GAICD, Chair of the Central Adelaide Local Health Network Governing Board, says the Commission’s national model will support boards to understand their organisation’s safety culture so they can proactively identify and address risk.

‘If you don't know the safety culture of your organisation, how can you feel assured that the business is operating effectively or is providing good care?’ Professor Searle says.

Effective clinical governance has numerous organisational advantages.

It gives board directors a much greater degree of comfort that the whole organisation is working systematically towards high-quality care. Staff feel more supported, and workforce wellbeing and retention are improved.

It also means board members can fulfil and enact their responsibility as a director – and that they can sleep more easily knowing there is reduced risk of a catastrophic safety incident they never saw coming.