Introduction: clinical governance and the wider quality agenda -- Structure and accountability -- Achieving change in clinical governance -- Quality initiatives: the process of clinical effectiveness pt.1: Research and development and guideline formation -- Quality initiatives: the process of clinical effectiveness pt. 2: Getting the evidence into practice (evidence-based practice, care pathways and clinical audit) -- Complaints and risk management -- Support for clinical governance -- The user perspective on the quality of care -- Evidence-based management -- Some legal and ethical principles -- Appendix