hasan
It is very unlikely that there is a department in any trust within the UK that does not have an active clinical governance programme already going.
Shipman and bristol set the ball rolling with regards to the clinical governance front so there should be at least 10 years of work already under the bridge.
This question will natually relate to the department and hospital that you are applying for.It is a question that is really asking "what do you think about the clinical governance in this department and how would you improve it".
The answer to this hidden question is really based on what you find out on your pre-interview visit.
Remember that you will have the senior management of the panel. They don't want to know how poor their clinical governance is (the medical director is ultimately resposnsible with part responsibility from the departmental clinical director). What they want to know is how good it is and if it doesn't meet your expectations or if you have ways to imporve it then share them with the panel.
Try and play off the importance of clinical governance which can be related to actual cost savings. The management want to hear about increased efficiency and cost effeectivness whilst the clinicians want to hear about high quality of care (sometimes above financial considerations).
A good way to do this ( and it is increibly difficult at times) is to talk of ways that clinical governance can increase the quality of care whilst reducing trust expenditure!! and yes it can be done.
For example, the CNST (clinical negligence schemes for trusts
http://www.nhsla.com/Claims/Schemes/CNST/ ) is a central fund that all 330 nhs trusts in the uk voluntarily contribute to.It acts as an insurance policy so that no one legal negligence claim (which could cost the trust millions) could put the trust out of business. Each trust makes contributions on a yearly basis and if they get sued the money comes form the CNST.
However the policy premium is directly linked to the risk within the department. 3 levels are present. The bottom level is high risk and attracts a high premium. A low level is low risk and attracts the lowest premium. To get from level 1 to 3 you need to demonstrate to the CNST that you have a clinical governance framework that works. For example the number of consultant sessions covering your service is one measure. Obviously if you have your unit staffed by non-consultants all of the time it is deemed a higher risk and you will need to pay a higher premium. By adhearing to some of these rules you get to pay a lower premium and at the same time your service and quality of care is improved.
I'll leave you with jus the one answer to the clinical governance question as books have been written on the subject.
A good book to read is An introduction to quality assurance in health care by avedis donabedian and also the medical manager, a practical guide to clinicans by anthony e young. Both books give a good guide to clinical governance issues.
regards
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