Article review: “Clinical governance and the drive for quality improvement in the new NHS in England” by Scally & Donaldson (1998)

Article review: “Clinical governance and the drive for quality improvement in the new NHS in England” by Scally & Donaldson (1998)

Scally and Donaldson are best friends who fight crime in the in King’s Lynn area in their spare time. Scally is street smart whereas Donaldson is book smart. Their adventures always reveal a moral lesson about the importance of compromise in teamwork.

Double act: Scally & Donaldson

In 1997 (two decades ago now!) the Government issued guidance that health organisations now had a duty to improve quality rather than just attain financial and activity targets. This was in response to concerns that the Tory ‘marketplace model’ for the NHS had led to price being more important that quality of care. They were to improve quality through clinical governance.

“Clinical governance is being held accountable for continuously improving the quality of services, which safeguards high standards of care”

On a practical level clinical governance can be split into the areas of: Read more

Trends and Contexts in Occupational Therapy

Trends and Contexts in Occupational Therapy


Trends are a something (like a style of therapeutic practice) that is popular at the moment. Example:

  • mindfulness
  • adult colouring books
  • active ageing
  • life stories
  • use of Sensory Integration in settings other than paediatrics
  • paternalism being challenged
  • holistic approach to health
  • in society, being in debt is acceptable whereas in the past it wasn’t

Contexts are the circumstances that influence or affect something (like a trend):

  • Politics and the resulting government policies on access to services and funding
  • the culture
  • the attitudes of individual therapists


Contexts in healthcare are often influenced by political and legislation, because in the UK healthcare is funded by the government because we have the NHS. In other countries where healthcare is paid for by insurance or individuals consumers, it may be be more heavily influenced by these other factors?  Anyway, in the UK the Care Act (2014) is a recent policy that supersedes the previous health-related acts such as NHS act (2006). Because of what the Care Act (2014) states, some expected trends to happen in healthcare will be

  • integration of services:
    • health and social care working more closely
    • between hospitals and GPS (primary & secondary care)
    • between mental and physical care
How do I get OT shadowing experience? What do they ask at OT MSc course interviews? And other questions.

How do I get OT shadowing experience? What do they ask at OT MSc course interviews? And other questions.

The lowdown

Recently I got to represent Occupational Therapy at a postgraduate event, and it was great being able to help future OT students by offering some advice here and there. A lot of them commented that it was really helpful having current students there, as well as the University’s admission tutors, and it made me cast my mind back to the stressful months & weeks before my interview when I’d have sat through the every episode of Big Bang Theory in return for a student godmother to ask three questions to.otter student

Below are some of the most common questions together with the advice I gave:

How do I get OT shadowing experience?

You can try contacting local hospitals’ OT departments and asking them. However in my experience, the success rate for people obtaining shadowing experience this way is low. A better way is to use your existing contacts, and think outside the box. By this I mean think about who you already know, and think about all the places where OTs work (clue: it’s not just hospitals).

Some ideas are:

Traditional settings– hospitals, outpatient clinics, schools, nurseries, supported living facilities, day centres for people with learning disabilities, community health teams, hand clinics.

Non-traditional settings– mental health/psychiatric facilities, equine therapy/animal assisted therapies, assistive technology centres, research labs, prosthetic/orthotic clinics, chronic pain management clinics, palliative care/hospices, oncology depts, military hospitals/rehab centres, private schools, independent practitioners, prisons/criminal justice system, vocational rehabilitation, community-based or mental health outreach teams, A&E.

OTs are generally acknowledged to be the nicest people you’ll ever meet. The ones that I contacted ranged from willing-to-help to bent-over-backwards-to-offer-clinical-contact-and-photocopied-relevant-book-pages-for-me. Even if you don’t have a family member who’s an OT, ask around if anyone knows of one and you will be surprised. Then be shameless in approaching them directly for help! The worst they can do is politely decline, but I guarantee they won’t. Read more

What is Evidence Based Practice? Why does it matter in everyday life?

What is Evidence Based Practice? Why does it matter in everyday life?

A definition of Evidence Based Practice (EBP) is:

 “the conscientious, explicit and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health (and social) care decisions” (Sackett et al. 2000: 71-72)

Evidence based practice will be important to me when I am making clinical decisions on my caseload as an Occupational Therapist.

Evidence Based Practice

It is also important to me a ‘civilian’ and someone who uses the NHS healthcare system in the UK.  When I last visited the doctor, the antibiotics he prescribed would have been chosen from 100s available on the market, and it’s likely his decision was influenced (or dictated?) by the research done on the best antibiotic for my particular problem. It won’t have been one that would 100% guaranteed cure my problem, but the evidence would have pointed to the fact that there was  very high chance it would. So s/he tried that one first. Read more